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Justin Pike Ollis

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

3200 Northline Ave, Suite 200, Greensboro, NC 27408-7602

PECOS Enrollment

This provider is enrolled in PECOS as JUSTIN OLLIS.

Based on the most recent information from CMS, provider Justin Pike Ollis is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 11:21 AM.

Profile Details

Provider ID
1932207701
Provider Type
Individual
Full Name
Ollis, Justin Pike
Credential
PA-C

Gender
Male
Sole Proprietor
No
Enumeration Date
9/20/2006
Last Updated
2/27/2026

Contact Information

Practice Location

3200 Northline Ave, Suite 200, Greensboro, NC 27408-7602

(336) 545-5000

(336) 545-5020

Mailing Location

100 Kimel Forest Dr, Winston Salem, NC 27103-6074

(336) 716-2255

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 0010-06348 North Carolina

Justin Pike Ollis

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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Rayburn, Shawn Montgomery

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