BLACK OLIVE HEALTH CARE CLINIC
NPI 1316695380
Nurse Practitioner - Primary Care in Columbus, OH

Active since March 17, 2022CLIA 36D2340984 · Waiver
1415 E DUBLIN GRANVILLE RD STE 100C, COLUMBUS, OH 43229(614) 943-3776(860) 261-0210 Get Directions Write a Review

NPPES record last updated: March 16, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Black Olive Health Care Clinic NPPES

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

BLACK OLIVE HEALTH CARE CLINIC (NPI 1316695380) is a healthcare organization registered as a primary care in Columbus, Ohio and active in the NPI registry since March 2022. The organization holds a CLIA Waiver certificate valid through March 25, 2028 and lists Edeisha Brooks, Aprn, as its authorized official.

NPPES Registry Identity

NPI1316695380
Entity TypeOrganization
Primary Taxonomy363LP2300X
Legal Business NameBLACK OLIVE HEALTH CARE CLINIC
Location Address1415 E DUBLIN GRANVILLE RD STE 100CColumbus, OH 43229-3311
Mailing Address860 Oakland Park AveColumbus, OH 43224-3258 · (419) 295-8811
Fax(860) 261-0210
Organization SubpartNo
Authorized OfficialEdeisha BrooksAprn · (419) 295-8811
Enumeration DateMarch 17, 2022
Last NPPES UpdateMarch 16, 2026
NPPES CertifiedMarch 16, 2026
NPI 1316695380 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
1415 E DUBLIN GRANVILLE RD STE 100C, Columbus, OH 43229

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 36D2340984

Black Olive Health · Columbus, OH
Active · expires Mar 25, 2028
CLIA Number36D2340984
Laboratory TypePractitioner Other
Certificate Effective DateMarch 26, 2026
Certificate Expiration DateMarch 25, 2028
Laboratory DirectorEdeisha Brooks
Laboratory Phone(419) 564-0105
Laboratory LocationBlack Olive Health1415 E Dublin Granville Rd Ste 110C, Columbus, OH 43229
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

Nurse Practitioner (Family)
1415 E DUBLIN GRANVILLE RD STE 100C
COLUMBUS, OH 43229

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Black Olive Health Care Clinic's NPI number?

The NPI number for Black Olive Health Care Clinic is 1316695380. It was assigned to this organization in the NPPES registry on March 17, 2022.

Where is Black Olive Health Care Clinic located?

Black Olive Health Care Clinic is located at 1415 E Dublin Granville Rd Ste 100C, Columbus, OH 43229. The listed phone number is (614) 943-3776.

What is Black Olive Health Care Clinic's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Does Black Olive Health Care Clinic hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D2340984) is associated with this NPI, valid through March 25, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Black Olive Health Care Clinic accept?

Health plans from Anthem Blue Cross and Blue Shield list Black Olive Health Care Clinic as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Black Olive Health Care Clinic was last updated on March 16, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.