NPIMap

Individual provider Active NPI

Olivia Blue

  • Physician Assistant
  • Kernersville, NC
National Provider Identifier
1932574985
Registry record updated Aug 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1635 NC Highway 66 S Ste 235
Kernersville, NC 27284-3855
Phone
(336) 992-4800
NPI assigned
Dec 2, 2015
Last updated
Aug 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1635 NC Highway 66 S Ste 235
Kernersville, NC 27284-3855

Mailing address

PO Box 751803
Charlotte, NC 28275-1803
Phone (336) 564-4341

Other practice location 1

4012B Battleground Ave Ste 1020
Greensboro, NC 27410-9296
Phone (336) 765-9328

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address oblue178054@direct.novanthealth.org
Direct Messaging Address oblue195320@direct.conehealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160329000826 NC Practitioner - Physician Assistant 9032416532 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
92.52 of 100Reported as group
Quality
83.13
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alamance Regional Medical Center, Inc. CurrentSince Jul 20, 2019 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation Physician Assistant CurrentSince Jul 20, 2019 Accepting new patients
Alamance Regional Medical Center, Inc CurrentSince Jul 20, 2019 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Jul 20, 2019 Accepting new patients
Novant Health Medical Group, LLC Past Accepting new patients
Novant Medical Group, Inc. PastSince Oct 25, 2020 Accepting new patients
Greensboro Radiology, PA Physician Assistant PastSince Aug 15, 2021 Accepting new patients

Locations

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

1131 N Church St
Greensboro, NC 27401
Phone (336) 358-5100

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

1635 NC Highway 66 S
Ste 235
Kernersville, NC 27284
Phone (336) 992-4800

Interoperability endpoints

  • Direct secure messaging: oblue178054@direct.novanthealth.org
  • Direct secure messaging: oblue195320@direct.conehealth.com

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1449014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1932574985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751803",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751803",
            "telephone_number": "336-564-4341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 NC HIGHWAY 66 S STE 235",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272843855",
            "telephone_number": "336-992-4800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4012B Battleground Ave Ste 1020",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274109296",
            "country_code": "US",
            "telephone_number": "336-765-9328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLUE",
        "first_name": "OLIVIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-02",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "oblue178054@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "4012B Battleground Ave Ste 1020",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274109296",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "oblue195320@direct.conehealth.com",
            "affiliation": "N",
            "endpointDescription": "Cone Health Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1635 Nc Highway 66 S Ste 235",
            "city": "Kernersville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "272843855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kernersville, NC

Sources for this page

Verify at the official NPI Registry.