Shantial Latoya Oliver, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-05806 Issued in NC

Practice address

10030 Gilead Rd Ste 245
Huntersville, NC 28078-7545

Phone

(704) 895-9390

Fax

(704) 546-5948

NPI assigned

Jul 21, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, SC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novant Health Prep II LLCGroup PAC ID 1052835311, shared by 2 NPIs, 47 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Novant Health Prep II LLC

  • Surgery Physician
  • Charlotte, NC
  • NPI 1952107385
  Medicare reassignment NPD
• Surgical Specialists of Charlotte, P.a.

  • Surgery Physician
  • Charlotte, NC
  • NPI 1073599734

  SC

  Medicare reassignment NPD
• Novant Health Prep II LLC

  • Surgery Physician
  • Rock Hill, SC
  • NPI 1033910708
  Medicare reassignment NPD
• Caromont Medical Group Inc

  • Family Medicine Physician
  • Gastonia, NC
  • NPI 1356314272
  Medicare reassignment
• Piedmont Physician Network LLC

  • Internal Medicine Physician
  • York, SC
  • NPI 1194277186
  Medicare reassignment
• Caromont Medical Group Inc

  • Family Medicine Physician
  • Gastonia, NC
  • NPI 1700213956
  NPD
• Caromont Medical Group Inc

  • Family Medicine Physician
  • Stanley, NC
  • NPI 1972301380
  NPD
• Novant Health Prep II LLC

  • Surgery Physician
  • Huntersville, NC
  • NPI 1518763945
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1437436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1568847564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 604350",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282604350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10030 GILEAD RD STE 245",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280787545",
            "telephone_number": "704-895-9390",
            "fax_number": "704-546-5948"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2391 Court Dr Ste 120B",
            "address_purpose": "LOCATION",
            "city": "Gastonia",
            "state": "NC",
            "postal_code": "280542196",
            "country_code": "US",
            "telephone_number": "704-874-0095",
            "fax_number": "704-866-8680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "SHANTIAL",
        "middle_name": "LATOYA",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-21",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0010-05806",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-05806",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4144",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Ifeoma Obi, MD
• Malazia Janaya Odom, LCSW-A
• Chloe Ohara, RBT
• Benson Chukwuemeka Okeiyi, MD
• Grace Eseohe Olatunde
• Omega Careone Services
• One Heart Ministries
• Alexandria Atuahene Opata, M.D.
• Open My H.E.a.R.T., Inc. (Helping Empower and Rebuild Tenacity)
• Christine Opre, IBCLC

• Physician Assistant in Huntersville, NC
• Providers in Huntersville, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.