Mary Olson, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Practice address

522 N New Ballas Rd Ste 201
Saint Louis, MO 63141-6819

Phone

(314) 833-4210

NPI assigned

Apr 21, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. Louis Center for Cognitive Health LLCGroup PAC ID 1456600311, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mary.olson.1@20107.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/20107/brand/1/csg/1/fhir/r4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St. Louis Center for Cognitive Health, LLC

  • Clinical Neuropsychologist
  • Creve Coeur, MO
  • NPI 1720576663
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1650499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1174267660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 N NEW BALLAS RD STE 201",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416819",
            "telephone_number": "314-833-4210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 N NEW BALLAS RD STE 201",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416819",
            "telephone_number": "314-833-4210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSON",
        "first_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-21",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Christine Olson, D.O.
• Jeffrey Jay Olson, MD
• John A Olson Jr., MD
• Kenneth Michael Olson, P.A. - C
• Marielle Antoinette Olson, RDN, LD
• Nathanael Olson
• Nicole Marie Olson, PTA
• Patrick David Olson, MD
• Stephen Michael Olson, M.D.
• Tracy M Olson, PMHNP

• Clinical Neuropsychologist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Neuropsychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.