Active NPI
Randall L. Oliver, M.D., P.C.
- Clinic/Center
- Evansville, IN
National Provider Identifier
1922038249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinic/Center
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000089152 | Other | IN | ANTHEM FAMILY PRACTICE |
| 64872484 | Medicaid | KY | |
| 719364 | Other | IN | AFFORDABLE |
| 10643 | Other | IN | HEALTHSOURCE |
| 169425 | Other | IN | HEALTHLINK |
| 1006173 | Other | IN | CHAMPUS |
| 659100 | Other | IN | PRINCIPAL |
| 0000000386753 | Other | IN | ANTHEM PAIN MGMT |
| 100180970A | Medicaid | IN |
Other names 1
- OLIVER HEADACHE AND PAIN CLINIC
National Provider Directory
National Provider DirectoryLocations
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.
-
- Family Nurse Practitioner
- Evansville, IN
- NPI 1558742197
-
- Family Medicine Physician
- Orange Park, FL
- NPI 1609828110
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.