Individual provider Active NPI

Andrew Blaine Oliver Jr., MD

  • Obstetrics & Gynecology Physician
  • Shelby, NC
National Provider Identifier
1760474456
Registry record updated Dec 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
27960 Issued in NC
Practice address
200 S Post Rd
Shelby, NC 28152-6269
Phone
(704) 484-5100
Fax
(704) 484-5118
NPI assigned
Aug 18, 2005
Last updated
Dec 6, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 27960 NC
Obstetrics & Gynecology Physician 207V00000X 27960 NC Primary

Addresses

Primary practice location

200 S Post Rd
Shelby, NC 28152-6269

Mailing address

315 E Grover St
Shelby, NC 28150-3919
Phone (704) 484-5100

Other identifiers 1

IdentifierTypeStateIssuer
891044AMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20071026000141 NC Practitioner - Obstetrics/Gynecology 2365539103 Reassigns benefits to 2 organizations
I20250923001842 TX Practitioner - Obstetrics/Gynecology 2365539103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Great Plains Tribal Chairmen's Health BoardGroup PAC ID 0648609917, 64 clinicians

Practice addresses (Care Compare)

3200 Canyon Lake Dr
Rapid City, SD 57702-8114
Phone 60535525002356

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
27960NCMDAmbulatory Care Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc Obstetrics & Gynecology CurrentSince Jan 10, 2022 Accepting new patients
Great Plains Tribal Chairmen's Health Board CurrentSince Aug 18, 2025 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Jan 10, 2022 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Atrium Health North Market Network LLC Obstetrics & Gynecology CurrentSince Jan 1, 2023 Accepting new patients

Locations

2001 Vail Ave
Charlotte, NC 28207
Phone (704) 304-5000

4525 Cameron Valley Pkwy
Ste 4100D
Charlotte, NC 28211
Phone (704) 801-7310

447 McAlister Rd
Ste 3500
Lincolnton, NC 28092
Phone (980) 212-6230

3200 Canyon Lake Dr
Rapid City, SD 57702
Phone (605) 355-2282

3200 Canyon Lake Dr
Ste 1
Rapid City, SD 57702
Phone (605) 355-2500

Interoperability endpoints

  • Direct secure messaging: aoliver915111@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 5

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": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1760474456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 E GROVER ST",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281503919",
            "telephone_number": "704-484-5100",
            "fax_number": "704-484-5220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S POST RD",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281526269",
            "telephone_number": "704-484-5100",
            "fax_number": "704-484-5118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "ANDREW",
        "middle_name": "BLAINE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "27960",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "27960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891044A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby, NC

Sources for this page

Verify at the official NPI Registry.