Individual provider Active NPI

Myra Martha Demissie, OTR/L

  • Occupational Therapist
  • Oklahoma City, OK
National Provider Identifier
1053829341
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5664 Issued in OK
Practice address
2401 NW 23Rd St Ste 1C
Oklahoma City, OK 73107-2420
Phone
(405) 355-3239
NPI assigned
Jan 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5664 OK Primary
Occupational Therapist 225X00000X 0119010519 VA
Occupational Therapist 225X00000X 07952 MD
Occupational Therapist 225X00000X 17-04253 KS
Occupational Therapist 225X00000X OT010001546 DC

Addresses

Primary practice location

2401 NW 23Rd St Ste 1C
Oklahoma City, OK 73107-2420

Mailing address

928 NE 17TH St
Oklahoma City, OK 73105-8408

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
07952MDMDClinical Social Worker
OT010001546DCMDOccupational Therapist
17-04253KSMDOccupational Therapist
0119010519VAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bilingual Pediatric Therapies CurrentSince Sep 15, 2024 Accepting new patients
Clearspeech Speech and Language Past Accepting new patients

Locations

2401 NW 23rd St
Ste 1C
Oklahoma City, OK 73107

Organizations & group practices 2

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": "1516406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1053829341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 NE 17TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731058408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 NW 23RD ST STE 1C",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731072420",
            "telephone_number": "405-355-3239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMISSIE",
        "first_name": "MYRA",
        "middle_name": "MARTHA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-20",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OK",
            "license": "5664",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119010519",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "07952",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KS",
            "license": "17-04253",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "DC",
            "license": "OT010001546",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2025; 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.