Organization Active NPI

Randall L. Oliver, M.D., P.C.

  • Clinic/Center
  • Evansville, IN
National Provider Identifier
1922038249
Registry record updated Mar 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
RANDALL L. OLIVER, M.D., P.C.
Practice address
1101 Professional Blvd
Evansville, IN 47714-8016
Phone
(812) 477-7246
Fax
(812) 477-7240
NPI assigned
Jul 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2013

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

Authorized official

Name
Randall Lee Oliver, M.D.
Title
Owner/Physician
Phone
(812) 477-7246

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1101 Professional Blvd
Evansville, IN 47714-8016

Mailing address

PO Box 6810
Evansville, IN 47719-0810
Phone (812) 477-7246

Other identifiers 9

IdentifierTypeStateIssuer
000000089152OtherINANTHEM FAMILY PRACTICE
64872484MedicaidKY
719364OtherINAFFORDABLE
10643OtherINHEALTHSOURCE
169425OtherINHEALTHLINK
1006173OtherINCHAMPUS
659100OtherINPRINCIPAL
0000000386753OtherINANTHEM PAIN MGMT
100180970AMedicaidIN

Other names 1

  • OLIVER HEADACHE AND PAIN CLINIC Doing business as

National Provider Directory

National Provider Directory

Locations

2828 Mount Vernon Ave
Evansville, IN 47712
Phone (812) 425-9824

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363651200000",
    "number": "1922038249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6810",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477190810",
            "telephone_number": "812-477-7246",
            "fax_number": "812-477-7240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 PROFESSIONAL BLVD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477148016",
            "telephone_number": "812-477-7246",
            "fax_number": "812-477-7240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDALL L. OLIVER, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-03",
        "last_updated": "2013-03-19",
        "status": "A",
        "authorized_official_last_name": "OLIVER",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "812-477-7246",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM FAMILY PRACTICE",
            "identifier": "000000089152",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64872484",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AFFORDABLE",
            "identifier": "719364",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHSOURCE",
            "identifier": "10643",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "169425",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "1006173",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRINCIPAL",
            "identifier": "659100",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PAIN MGMT",
            "identifier": "0000000386753",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100180970A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OLIVER HEADACHE AND PAIN CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.