Olive Branch Way PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

OLIVE BRANCH WAY PLLC

Practice address

245 Riverside Ave Ste 100
Jacksonville, FL 32202-4930

Phone

(904) 575-0628

Fax

(904) 506-1326

NPI assigned

Oct 15, 2025

Organization subpart

No

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

Authorized official

Name

Sherekia Hales, PMHNPNPI 1124590047

Title

Owner

Phone

(904) 710-0398

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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

• Sherekia Lajuan Hales, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Austin, TX
  • NPI 1124590047

  FL

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1760486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760486400000",
    "number": "1972479137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 WESCONNETT BLVD UNIT 14846",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322387769",
            "telephone_number": "904-575-0628",
            "fax_number": "904-506-1326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 RIVERSIDE AVE STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322024930",
            "telephone_number": "904-575-0628",
            "fax_number": "904-506-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLIVE BRANCH WAY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-15",
        "last_updated": "2025-10-15",
        "certification_date": "2025-09-29",
        "status": "A",
        "authorized_official_last_name": "HALES",
        "authorized_official_first_name": "SHEREKIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-710-0398",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Richard Olinzock, D.D.S.
• Anny Oliva Perez, DMD
• Arcadio J Oliva, MD
• Vivian Esther Olivares
• Lori M Olivarez, APRN
• Isabella Cristina Oliveira, PHARMD
• Aaron Joseph Oliver
• Alaria Oliver
• Ashley Oliver, LICSW
• Bertha W Oliver

• Clinic/Center in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.