Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Olivia Nicole Moore

Individual provider Physician Assistant · NPI 1104513589

Olivia Nicole Moore is a Physician Assistant in Columbia, South Carolina. Graduated from University of South Carolina School of Medicine in 2023, 3 years ago. Practices with Prisma Health Medical Group-Midlands, a 1,018-clinician group and accepts Medicare assignment. Licensed in South Carolina.

Years since qualifying
3
Trained at
University of South Carolina School of Medicine
Licensed in
SC
In the registry since
2023
Specialties on file
2
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Practice location Address checks out

1333 Taylor St Ste 6F
Columbia, SC 29201-2953
Phone: (803) 296-3273
Fax: (803) 296-7061
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 4894 (SC)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1104513589
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 18, 2023
Last updated in NPPESJune 28, 2023
Certification dateJune 28, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolUNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE
Graduated 2023 (3 years in practice)
Group practice Prisma Health Medical Group-Midlands — 1018 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Columbia