Angela Suzzanne Olomon, DO, FACN

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

R1J41 Issued in MO

Practice address

900 E San Martin St
Bolivar, MO 65613-2893

Phone

(417) 326-7272

Fax

(417) 326-2193

NPI assigned

Apr 12, 2006

Last updated

Jul 23, 2025By 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 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

Kansas City University of Med & Biosciences, College of Osteo Med, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northwoods Psychiatric Services IncGroup PAC ID 7012979974, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Citizens Memorial Hospital Hospital, Bolivar, MO, CCN 260195

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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

• Northwoods Psychiatric Services Inc

  dba Pomme de Terre Wellness Clinic

  • Psychiatry Physician
  • Bolivar, MO
  • NPI 1417902305
  Medicare reassignment Care Compare group NPD
• Citizens Memorial Healthcare

  • Surgery Physician
  • Bolivar, MO
  • NPI 1568566131

  Psychiatry

  Medicare reassignment NPD
• Ozarks Resource Group

  dba Ozarks Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Hermitage, MO
  • NPI 1639421050
  Medicare reassignment NPD
• Citizens Memorial Healthcare

  dba CMH Willard Medical Center

  • Rural Health Clinic/Center
  • Willard, MO
  • NPI 1568127397
  NPD
• Ozarks Resource Group

  dba Ozarks Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Urbana, MO
  • NPI 1659942027
  NPD
• Comprehensive Wellness Clinic

  • Psychiatry Physician
  • Bolivar, MO
  • NPI 1619062445
  NPD (past)
• Southwest Missouri Homecare, LLC

  dba Access Home Health Agency

  • Home Health Agency
  • Springfield, MO
  • NPI 1316129208
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Citizens Memorial Hospital District

  dba Citizens Memorial Hospital

  • General Acute Care Hospital
  • Bolivar, MO
  • NPI 1003981549
  Care Compare affiliation

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1487618062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 49",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656130049",
            "telephone_number": "417-326-7272",
            "fax_number": "417-326-2193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 E SAN MARTIN ST",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656132893",
            "telephone_number": "417-326-7272",
            "fax_number": "417-326-2193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLOMON",
        "first_name": "ANGELA",
        "middle_name": "SUZZANNE",
        "name_prefix": "Dr.",
        "credential": "DO, FACN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "R1J41",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "MA3677001",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MC ID #",
            "identifier": "P00230684",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "242734010",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "242734036",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Bolivar, MO
• Providers in Bolivar, MO by specialty
• Psychiatry Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; 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.