Mark F. Olsen M.D., P.a.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

C6864 Issued in AR

Legal business name

MARK F. OLSEN M.D., P.A.

Doing business as

Olsen Clinic

Practice address

212 W Monroe Ave Ste B
Lowell, AR 72745-9451

Phone

(479) 770-4100

Fax

(479) 770-0262

NPI assigned

Dec 6, 2010

Last updated

Oct 13, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mark F Olsen, M.D.NPI 1831108430

Title

Office Manager

Phone

(479) 770-4100

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Olsen Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark F Olsen, M.D.

  • Family Medicine Physician
  • Lowell, AR
  • NPI 1831108430
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1291593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665619200000",
    "number": "1871896373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "439 E REDBUD LN",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727033959",
            "telephone_number": "479-770-4100",
            "fax_number": "479-770-0262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 W MONROE AVE STE B",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727459451",
            "telephone_number": "479-770-4100",
            "fax_number": "479-770-0262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK F. OLSEN M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-06",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A",
        "authorized_official_last_name": "OLSEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "479-770-4100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AR",
            "license": "C6864",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "5G789",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Olsen Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Olsen Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Primary Care Clinic/Center in Lowell, AR
• Providers in Lowell, AR by specialty
• Primary Care Clinic/Center in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.