Individual provider Active NPI

Olivia Cain, PA-C

  • Medical Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1780027243
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601006637 Issued in MI
Practice address
350 Lafayette Ave SE Ste 308
Grand Rapids, MI 49503-4656
Phone
(616) 840-8000
NPI assigned
Apr 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601006637 MI Primary

Addresses

Primary practice location

350 Lafayette Ave SE Ste 308
Grand Rapids, MI 49503-4656

Mailing address

350 Lafayette Ave SE Ste 308
Grand Rapids, MI 49503-4656
Phone (616) 840-8000

Other identifiers 1

IdentifierTypeStateIssuer
5601006637OtherMILICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20130613000564 MI Practitioner - Physician Assistant 5294974739 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Free Bed Rehabilitation Hospital CurrentSince Apr 4, 2025 Accepting new patients
Mary Free Bed Rehabilitation Hospital PastSince Apr 27, 2025 Accepting new patients

Locations

235 Wealthy St SE
Grand Rapids, MI 49503
Phone (616) 242-0422

Interoperability endpoints

  • Direct secure messaging: ocain177352@direct.covenanthealthcare.com

Organizations & group practices 4

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": "1365984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1780027243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 LAFAYETTE AVE SE STE 308",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034656",
            "telephone_number": "616-840-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 LAFAYETTE AVE SE STE 308",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034656",
            "telephone_number": "616-840-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAIN",
        "first_name": "OLIVIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-15",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601006637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "5601006637",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.