Olivia Penn Madan, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

60988 Issued in TN

Practice address

1914 Charlotte Ave Ste 101
Nashville, TN 37203-2231

Phone

(615) 327-0303

NPI assigned

Jun 6, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Plastic Surgery Affiliates

  • Plastic Surgery Physician
  • Nashville, TN
  • NPI 1659549608
  NPD (past)

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

{
    "created_epoch": "1402012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613433600000",
    "number": "1861805921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 S HAWTHORNE RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271034416",
            "telephone_number": "864-650-6228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1914 CHARLOTTE AVE STE 101",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372032231",
            "telephone_number": "615-327-0303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Blvd",
            "address_2": "Wake Forest Baptist Medical Hospital",
            "address_purpose": "LOCATION",
            "city": "Winston-Salem",
            "state": "NC",
            "postal_code": "27103",
            "country_code": "US",
            "telephone_number": "337-716-2011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADAN",
        "first_name": "OLIVIA",
        "middle_name": "PENN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-06",
        "last_updated": "2021-02-16",
        "certification_date": "2021-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "TN",
            "license": "60988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRACTICE NPI",
            "identifier": "1659549608",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina L Macmurdo-France, MD
• Brandon Daryl Macon, MS
• Daniel L Macri
• Regina Ann Macri
• Chelsea Leigh Shannon Macwilliam, BCBA
• Reka Madari
• Dana Leigh Madden, BA
• Jeanne Elizabeth Madden, P.A.
• Misty Michele Madden, BCBA
• Lillian Quevon Maddox-Whitehead, BSW

• Plastic Surgery Physician in Nashville, TN
• Providers in Nashville, TN by specialty
• Plastic Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.