Individual provider Active NPI

Olin H Harbury, M.D.

  • Diagnostic Radiology Physician
  • Charlotte, NC
National Provider Identifier
1831195072
Registry record updated Dec 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
34029 Issued in NC
Practice address
700 E Morehead St
Ste 300
Charlotte, NC 28202-2788
Phone
(704) 334-7800
Fax
(704) 414-7512
NPI assigned
Jun 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 20631 SC
Diagnostic Radiology Physician 2085R0202X 34029 NC Primary

Addresses

Primary practice location

700 E Morehead St
Ste 300
Charlotte, NC 28202-2788

Mailing address

700 E Morehead St
Ste 300
Charlotte, NC 28202-2788
Phone (704) 334-7800

Other identifiers 1

IdentifierTypeStateIssuer
893912BMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34029NCMDDiagnostic Radiology Physician
20631SCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Ridge Healthcare Medical Group, Inc. Current Accepting new patients
Blue Ridge Healthcare Medical Group Inc Diagnostic Radiology Past Accepting new patients
Charlotte Radiology PA Diagnostic Radiology PastSince Sep 14, 2014 Accepting new patients

Locations

2134 14th Avenue Cir NW
Ste D
Hickory, NC 28601
Phone (828) 580-1236

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513728000000",
    "number": "1831195072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E MOREHEAD ST",
            "address_2": "STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022788",
            "telephone_number": "704-334-7800",
            "fax_number": "704-414-7512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E MOREHEAD ST",
            "address_2": "STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022788",
            "telephone_number": "704-334-7800",
            "fax_number": "704-414-7512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARBURY",
        "first_name": "OLIN",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2017-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "SC",
            "license": "20631",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "34029",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "893912B",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.