JENNY ANNE OLIVER PA-C
NPI 1053072173
Physician Assistant in Camp Lejeune, NC

Q: What is Jenny Oliver's NPI number?

The NPI number for Jenny Oliver is 1053072173. It was assigned to this individual provider in the NPPES registry on January 2, 2022. The provider is also known as Jenny Anne Van Wagoner.

Q: What is Jenny Oliver's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Jenny Oliver was last updated on April 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since January 02, 2022PECOS Enrolled

100 BREWSTER BLVD, CAMP LEJEUNE, NC 28547(910) 450-4357 Get Directions Write a Review

NPPES record last updated: April 24, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Dec 30, 2024, Nov 14, 2023, Aug 27, 2022 and 1 more (4 updates tracked since 2022).

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About Jenny Anne Oliver Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JENNY ANNE OLIVER PA-C (NPI 1053072173) is an individual physician assistant in Camp Lejeune, North Carolina, licensed in North Carolina (0010-14138) and active in the NPI registry since January 2022. She is enrolled in Medicare PECOS and maintains a secondary practice location in Hartford.

NPPES Registry Identity

NPI1053072173

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameJENNY ANNE OLIVERCredential: PA-C

Location Address100 BREWSTER BLVDCamp Lejeune, NC 28547-2575

Mailing Address100 Brewster BlvdCamp Lejeune, NC 28547-2575

Phone(910) 450-4357

Sole ProprietorNo

Enumeration DateJanuary 2, 2022

Last NPPES UpdateApril 24, 20254 updates tracked since enumeration

NPPES CertifiedApril 23, 2025

✔ NPI 1053072173 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in NC · 0010-14138

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License 0010-14138 (NC)

100 BREWSTER BLVD, Camp Lejeune, NC 28547

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Other Names 1

Former Name (1)Jenny Anne Van Wagoner

Secondary Practice Location 1

Location 180 Seymour StHartford, CT 06102-8000 · Phone (860) 972-0000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jenny Anne Oliver Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28547 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

Established Patient

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. JUSTIN THOMAS DAUGHTRY D.O.

Emergency Medicine