Individual provider Active NPI

Tera Olivi

  • Psychiatric/Mental Health Nurse Practitioner
  • Jonesboro, AR
National Provider Identifier
1629939913
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
235192 Issued in AR
Practice address
615 E Matthews Ave Ste a
Jonesboro, AR 72401-3106
Phone
(870) 930-9090
NPI assigned
Nov 18, 2025
Last updated
Nov 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 235192 AR Primary

Addresses

Primary practice location

615 E Matthews Ave Ste a
Jonesboro, AR 72401-3106

Mailing address

615 E Matthews Ave Ste a
Jonesboro, AR 72401-3106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20260102003496 AR Practitioner - Nurse Practitioner 5496241085 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Bernards Hospital Inc.Group PAC ID 0941105480, 187 clinicians

Practice addresses (Care Compare)

2712 E Johnson Ave
Jonesboro, AR 72405-1874
Phone (870) 972-4100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
235192ARMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Bernards Hospital Inc. CurrentSince Dec 10, 2025 Accepting new patients
St. Bernards Hospital, Inc CurrentSince Dec 10, 2025 Accepting new patients

Locations

2712 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 268-4107

615 E Matthews Ave
Ste A
Jonesboro, AR 72401
Phone (870) 930-9090

1201 Fleming Ave
Jonesboro, AR 72401
Phone (870) 932-0440

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1763424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1629939913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 E MATTHEWS AVE STE A",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 E MATTHEWS AVE STE A",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013106",
            "telephone_number": "870-930-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVI",
        "first_name": "TERA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-18",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AR",
            "license": "235192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.