OLIVE BRANCH WAY PLLC
NPI 1972479137
Clinic/Center in Jacksonville, FL
About Olive Branch Way Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
OLIVE BRANCH WAY PLLC (NPI 1972479137) is a healthcare organization registered as a clinic/center in Jacksonville, Florida and active in the NPI registry since October 2025. The organization lists Sherekia Hales, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Olive Branch Way Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Olive Branch Way PLLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Olive Branch Way PLLC's NPI number?
The NPI number for Olive Branch Way PLLC is 1972479137. It was assigned to this organization in the NPPES registry on October 15, 2025.
Where is Olive Branch Way PLLC located?
Olive Branch Way PLLC is located at 245 Riverside Ave Ste 100, Jacksonville, FL 32202. The listed phone number is (904) 575-0628.
What is Olive Branch Way PLLC's specialty?
The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.
Is Olive Branch Way PLLC enrolled in Medicare?
Yes. Olive Branch Way PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Olive Branch Way PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Olive Branch Way PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Olive Branch Way PLLC was last updated on October 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# Olive Branch Way Pllc · NPI 1972479137
Clinic/Center organization in Jacksonville, Florida. Organization record, active in the CMS NPPES registry since October 15, 2025.
## Identity
- **NPI:** 1972479137 (Entity type: Organization)
- **Enumerated:** October 15, 2025
- **Primary specialty:** Clinic/Center · taxonomy 261Q00000X
- **Organization subpart:** No
- **Authorized official:** Sherekia Hales, OWNER
## Practice location
- **Address:** 245 RIVERSIDE AVE STE 100, Jacksonville, FL 32202-4930
- **Phone:** (904) 575-0628 · **Fax:** (904) 506-1326
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 15, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1972479137) · Data from the CMS NPPES public registry.