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

Olivia Rae Basile, PA-C

Individual provider Physician Assistant · NPI 1609652494

Olivia Rae Basile, PA-C is a Physician Assistant in Johns Creek, Georgia. Qualified in 2023, 3 years ago. Licensed in Georgia.

Years since qualifying
3
Licensed in
GA
In the registry since
2023
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

5400 Laurel Springs Pkwy Ste 1401
Johns Creek, GA 30024-6098
Phone: (678) 208-0165
Fax: (888) 814-0852
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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 13365 (GA)

Record details

NPI number1609652494
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 6, 2023
Last updated in NPPESDecember 8, 2025
Certification dateDecember 8, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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