Susan Jayne Olson, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

29752 Issued in SC

Practice address

1297 Professional Dr
Ste 104
Myrtle Beach, SC 29577-5713

Phone

(843) 712-1854

Fax

(843) 213-1681

NPI assigned

Dec 11, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1205996303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 WELCOME DR",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295795374",
            "telephone_number": "843-712-1854",
            "fax_number": "843-213-1681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1297 PROFESSIONAL DR",
            "address_2": "STE 104",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775713",
            "telephone_number": "843-712-1854",
            "fax_number": "843-213-1681"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1113 44th Ave N",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295775783",
            "country_code": "US",
            "telephone_number": "843-712-1854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSON",
        "first_name": "SUSAN",
        "middle_name": "JAYNE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "WI",
            "license": "26014",
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "SC",
            "license": "29752",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "29752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lynne Olivarez, DO
• David Oliver, DO
• Pearce Robert Ollar, DMD
• Diane Olski, MD
• Robert Christian Lee Olson, DO
• Optic Gallery, LLC (Optic Gallery Family Eye Care)
• Optimal Home Health Services, LLC
• Kenneth Peter Orbeck, D.O.
• Sophia Helena Orcutt, LMSW
• Kayla Oriley

• Psychiatry Physician in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Psychiatry Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.