Individual provider Active NPI

Olivia Johnson, MD

  • Family Medicine Physician
  • Four Oaks, NC
National Provider Identifier
1801454244
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
202302334 Issued in NC
Practice address
864 Black Creek Rd
Four Oaks, NC 27524-8314
Phone
(919) 936-3148
Fax
(919) 936-2900
NPI assigned
May 31, 2019
Last updated
Jun 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 94-09933 KS
Family Medicine Physician 207Q00000X 202302334 NC Primary

Addresses

Primary practice location

864 Black Creek Rd
Four Oaks, NC 27524-8314

Mailing address

864 Black Creek Rd
Four Oaks, NC 27524-8314
Phone (919) 936-3148

Other practice location 1

2451 University Hospital Dr Rm 714
Mobile, AL 36617-2300
Phone (251) 434-3475

Other practice location 2

1010 N Kansas St
Wichita, KS 67214-3124
Phone (316) 858-3460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20231013001793 NC Practitioner - Family Practice 6305172057 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Brody School of Medicine at East Carolina University, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Raleigh Durham Medical Group PAGroup PAC ID 2365409588, 80 clinicians

Practice addresses (Care Compare)

236 Butternut LN
Clayton, NC 27520-5857
Phone (919) 359-1011

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
202302334NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Raleigh Durham Medical Group PA Family Medicine CurrentSince Aug 31, 2023 Accepting new patients
Raleigh Durham Medical Group PA Family Medicine CurrentSince Aug 31, 2023 Accepting new patients
Raleigh Durham Medical Group, PA Family Medicine Past Accepting new patients

Locations

97 Cornerstone Dr
Cary, NC 27519
Phone (919) 460-0993

236 Butternut Ln
Clayton, NC 27520
Phone (919) 359-1011

864 Black Creek Rd
Four Oaks, NC 27524
Phone (919) 963-3148

7124 US Highway 64 E
Knightdale, NC 27545
Phone (919) 266-6211

Interoperability endpoints

  • Direct secure messaging: oliviajohnson@hfmpa.allscriptsdirect.net

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1559260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1801454244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "864 BLACK CREEK RD",
            "city": "FOUR OAKS",
            "state": "NC",
            "postal_code": "275248314",
            "telephone_number": "919-936-3148",
            "fax_number": "919-936-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "864 BLACK CREEK RD",
            "city": "FOUR OAKS",
            "state": "NC",
            "postal_code": "275248314",
            "telephone_number": "919-936-3148",
            "fax_number": "919-936-2900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2451 University Hospital Dr Rm 714",
            "address_purpose": "LOCATION",
            "city": "Mobile",
            "state": "AL",
            "postal_code": "366172300",
            "country_code": "US",
            "telephone_number": "251-434-3475",
            "fax_number": "251-434-3837",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1010 N Kansas St",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672143124",
            "country_code": "US",
            "telephone_number": "316-858-3460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "OLIVIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-31",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "94-09933",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "202302334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Four Oaks, NC

Sources for this page

Verify at the official NPI Registry.