Individual provider Active NPI

Mark Allan Oliver, DPT, ATC, CSCS

  • Orthopedic Physical Therapist
  • Abingdon, VA
National Provider Identifier
1710185301
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
2305202418 Issued in VA
Practice address
432 E Main St Ste a-1
Abingdon, VA 24210-3488
Phone
(276) 608-4468
Fax
(276) 240-1010
NPI assigned
Jul 5, 2007
Last updated
Jan 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical Therapist 2251S0007X 002567 WV
Orthopedic Physical Therapist 2251X0800X 2305202418 VA Primary
Athletic Trainer 2255A2300X 050102053 VA

Addresses

Primary practice location

432 E Main St Ste a-1
Abingdon, VA 24210-3488

Mailing address

432 E Main St Ste a-1
Abingdon, VA 24210-3488
Phone (276) 608-4468

Other identifiers 1

IdentifierTypeStateIssuer
0156094000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150729008322 VA Practitioner - Physical Therapist in Private Practice 8820152002 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

432 E Main St
Suite a 1
Abingdon, VA 24210-3488
Phone (276) 608-4468

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002567WVMDSports Physical Therapist
2305202418VAMDOrthopedic Physical Therapist
050102053VAMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Physical & Occupational Therapy Services Inc. Sports CurrentSince Feb 1, 2006 Accepting new patients

Locations

432 E Main St
Ste A-1
Abingdon, VA 24210
Phone (276) 608-4468

111 Saunders Ln
#B
Bluefield, VA 24605

111B Saunders Ln
Bluefield, VA 24605
Phone (276) 326-3611

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

NPI Registry JSON

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1710185301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "432 E MAIN ST STE A-1",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242103488",
            "telephone_number": "276-608-4468",
            "fax_number": "276-240-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "432 E MAIN ST STE A-1",
            "city": "ABINGDON",
            "state": "VA",
            "postal_code": "242103488",
            "telephone_number": "276-608-4468",
            "fax_number": "276-240-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "MARK",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "DPT, ATC, CSCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-05",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "WV",
            "license": "002567",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "VA",
            "license": "2305202418",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "050102053",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0156094000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Abingdon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.