Individual provider Active NPI

Darryl L Olive Jr., PA-C

  • Physician Assistant
  • Kansas City, MO
National Provider Identifier
1639494073
Registry record updated Feb 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2019013315 Issued in MO
Practice address
517 Campbell St
Kansas City, MO 64106-1213
Phone
(816) 699-2928
Fax
(816) 466-5969
NPI assigned
Mar 29, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2019013315 MO Primary
Kinesiotherapist 226300000X YA-34381 KS
Massage Therapist 225700000X 09980-01073 KS

Addresses

Primary practice location

517 Campbell St
Kansas City, MO 64106-1213

Mailing address

517 Campbell St
Kansas City, MO 64106-1213
Phone (816) 699-2928

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190529000739 MO Practitioner - Physician Assistant 1456604172 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
09980-01073KSMDMassage Therapist
YA-34381KSMDKinesiotherapist

Interoperability endpoints

  • Direct secure messaging: dolive134870@stormontvaildirect.org

Organizations & group practices 1

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": "1269820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771545600000",
    "number": "1639494073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 CAMPBELL ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641061213",
            "telephone_number": "816-699-2928",
            "fax_number": "816-466-5969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 CAMPBELL ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641061213",
            "telephone_number": "816-699-2928",
            "fax_number": "816-466-5969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVE",
        "first_name": "DARRYL",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-29",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2019013315",
            "primary": true
        },
        {
            "code": "226300000X",
            "taxonomy_group": "",
            "desc": "Kinesiotherapist",
            "state": "KS",
            "license": "YA-34381",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "KS",
            "license": "09980-01073",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.