Individual provider Active NPI

Bryan Vannuel Marsh, MD

  • Family Medicine Physician
  • Owasso, OK
National Provider Identifier
1033258959
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
19507 Issued in OK
Practice address
13616 E 103Rd Street N
Suite a
Owasso, OK 74055
Phone
(918) 274-8555
Fax
(918) 274-8556
NPI assigned
Feb 6, 2007
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 19507 OK Primary

Addresses

Primary practice location

13616 E 103Rd Street N
Suite a
Owasso, OK 74055

Mailing address

13616 E 103Rd St N
Ste a
Owasso, OK 74055-4586
Phone (918) 274-8555

Other identifiers 1

IdentifierTypeStateIssuer
100253080AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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

Enrollment IDStateProvider typePAC IDDetails
I20071026000627 OK Practitioner - Family Practice 7719074400 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
19507OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Resource Management, LLC Family Medicine CurrentSince Nov 18, 2015 Accepting new patients

Locations

10701 N Rockwell Ave
Oklahoma City, OK 73162
Phone (405) 470-1500

2929 S Garnett Rd
Tulsa, OK 74129
Phone (918) 665-1520

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: marshmediclinic.bryanmarshmd@144186.advancedmd-direct.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1033258959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13616 E 103RD ST N",
            "address_2": "STE A",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740554586",
            "telephone_number": "918-274-8555",
            "fax_number": "918-274-8556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13616 E 103RD STREET N",
            "address_2": "SUITE A",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "74055",
            "telephone_number": "918-274-8555",
            "fax_number": "918-274-8556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSH",
        "first_name": "BRYAN",
        "middle_name": "VANNUEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "19507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100253080A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owasso, OK

Sources for this page

Verify at the official NPI Registry.