Active NPI
Darryl L Olive Jr., PA-C
- Physician Assistant
- Kansas City, MO
National Provider Identifier
1639494073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2019013315
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09980-01073 | KS | MD | Massage Therapist |
| YA-34381 | KS | MD | Kinesiotherapist |
Interoperability endpoints
- 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.
-
- Geriatric Medicine (Internal Medicine) Physician
- Columbia, MO
- NPI 1396999686
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.