Active NPI
Myra Martha Demissie, OTR/L
- Occupational Therapist
- Oklahoma City, OK
National Provider Identifier
1053829341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5664
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 07952 | MD | MD | Clinical Social Worker |
| OT010001546 | DC | MD | Occupational Therapist |
| 17-04253 | KS | MD | Occupational Therapist |
| 0119010519 | VA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bilingual Pediatric Therapies | Current | 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.
-
- Speech-Language Pathologist
- Oklahoma City, OK
- NPI 1336444884
-
- Speech-Language Pathologist
- Beltsville, MD
- NPI 1407086689
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.