Active NPI
Gary J. Oliver
- Clinical Psychologist
- Siloam Springs, AR
National Provider Identifier
1962944579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 98-21P
- Practice address
- 2000 W University St
Siloam Springs, AR 72761-2112 - Phone
- (479) 524-7105
- NPI assigned
- Nov 14, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 98-21P | AR | Primary |
Addresses
Primary practice location
2000 W University St
Siloam Springs, AR 72761-2112
Mailing address
1450 Avery PL
Siloam Springs, AR 72761-2249
Phone (479) 524-7105
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 98-21P | AR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479081600000",
"number": "1962944579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1450 AVERY PL",
"city": "SILOAM SPRINGS",
"state": "AR",
"postal_code": "727612249",
"telephone_number": "479-524-7105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 W UNIVERSITY ST",
"city": "SILOAM SPRINGS",
"state": "AR",
"postal_code": "727612112",
"telephone_number": "479-524-7105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLIVER",
"first_name": "GARY",
"middle_name": "J.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-11-14",
"last_updated": "2016-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AR",
"license": "98-21P",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Siloam Springs, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.