SAMUEL JORDAN OLSON (D.O.) – Psychiatry Physician, NPI 1366974008

SAMUEL JORDAN OLSON (D.O.) is a healthcare provider. based in Little rock, Arkansas. specializing in PSYCHIATRY, OSTEOPATHIC MANIPULATIVE MEDICINE. They hold the professional credentials D.O.. They hold a License No. E-11906 (AR). The NPI Number for SAMUEL JORDAN OLSON (D.O.) is 1366974008

Main info

Male
Sole Proprietor
9 Years Of Experience
Accepts Medicare Assignment
Name
SAMUEL JORDAN OLSON (D.O.)
NPI
1366974008
Phone
(501) 526-8148
Address
4301 W MARKHAM ST # 589
Enumeration Date
31 March 2017
Last Update Date
7 October 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5016869585
Graduation Year
2017 (9 years ago)
PAC ID
0547532244
Group Practice PAC ID
6507863958
Professional Enrollment ID
I20190807003933
Address ID
AR722055432LI305XXSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:9State licenses:1Digital endpointsOther names

244 PSYCHIATRY in AR

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Provider Addresses for SAMUEL JORDAN OLSON (D.O.)

  • 589, West Markham Street, Little Rock, Pulaski County, Arkansas, 72201, United States

    LITTLE ROCK, AR 722057101

    Phone: (501) 526-8148

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-08-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190807003933IPsychiatryARTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes2313$0
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes2011$0
View full utilization report →

Insurance plans in this area (ZIP 72205)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6507863958View full group profile
NameSpecialtyState
Clinical PsychologistAR
-AR
Clinical PsychologistAR
P S Y C H I A T R YAR
Clinical PsychologistAR
P S Y C H I A T R YAR
P S Y C H I A T R YCA
P S Y C H I A T R YAR
Clinical PsychologistAR
P S Y C H I A T R YAR

Reviews

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Frequently asked questions

What federal number belongs to SAMUEL JORDAN OLSON (D.O.)?
The federal identifier for SAMUEL JORDAN OLSON (D.O.) is NPI 1366974008.
Is SAMUEL JORDAN OLSON (D.O.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize SAMUEL JORDAN OLSON (D.O.)'s specialty in plain language?
Clinically, the directory lists SAMUEL JORDAN OLSON (D.O.) with Psychiatry Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for SAMUEL JORDAN OLSON (D.O.)?
The page summarizes Little Rock, Arkansas for SAMUEL JORDAN OLSON (D.O.); expand the address list for detail.
How can I contact SAMUEL JORDAN OLSON (D.O.)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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