Individual provider Active NPI

Alyssa Danielle Marso, FNP, AGNP, BMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Columbia, MO
National Provider Identifier
1023610318
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
G173571 Issued in IA
Practice address
1400 Forum Blvd Ste 7a
Columbia, MO 65203-1997
Phone
(573) 200-6024
Fax
(573) 224-1862
NPI assigned
Nov 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2019040441 MO
Gerontology Nurse Practitioner 363LG0600X 2019001529 MO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X G173571 IA Primary
Family Nurse Practitioner 363LF0000X 2019040442 MO

Addresses

Primary practice location

1400 Forum Blvd Ste 7a
Columbia, MO 65203-1997

Mailing address

1400 Forum Blvd
Columbia, MO 65203-1938
Phone (573) 200-6024

Other names 1

  • Alyssa Danielle Johnson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2019040442MOMDFamily Nurse Practitioner
G173571IAMDPsychiatric/Mental Health Nurse Practitioner
2019040441MOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Marso Ventures LLC Current Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1605052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773014400000",
    "number": "1023610318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 FORUM BLVD",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652031938",
            "telephone_number": "573-200-6024",
            "fax_number": "573-224-1862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 FORUM BLVD STE 7A",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652031997",
            "telephone_number": "573-200-6024",
            "fax_number": "573-224-1862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSO",
        "first_name": "ALYSSA",
        "middle_name": "DANIELLE",
        "credential": "FNP, AGNP, BMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-11",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2019040441",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MO",
            "license": "2019001529",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G173571",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2019040442",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSSA",
            "last_name": "JOHNSON",
            "middle_name": "DANIELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2026; 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.