Individual provider Active NPI

Mary Ann Oliver

  • Counselor
  • Durham, NC
National Provider Identifier
1578072724
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
CSAC21548 Issued in NC
Practice address
1016 Broad St
Durham, NC 27705-4144
Phone
(919) 286-6766
NPI assigned
Sep 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CSAC21548 NC Primary

Addresses

Primary practice location

1016 Broad St
Durham, NC 27705-4144

Mailing address

1306 Paddock Dr Ste E100
Raleigh, NC 27609-4873
Phone (919) 790-7775

Other identifiers 1

IdentifierTypeStateIssuer
1568595510MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CSAC21548NCMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Care Solutions Inc Past Accepting new patients
Quality Care Health Services Inc. PastSince Aug 30, 2020 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1578072724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 PADDOCK DR STE E100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094873",
            "telephone_number": "919-790-7775",
            "fax_number": "919-790-9755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 BROAD ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054144",
            "telephone_number": "919-286-6766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "MARY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-20",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "CSAC21548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1568595510",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.