Ursula Wiese Marsh, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2007036957 Issued in MO

Practice address

219 Creekside Office Drive
Wentzville, MO 63385-3290

Phone

(636) 357-0136

Fax

(636) 639-1004

NPI assigned

Jan 15, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Safe Kids

  • Community Health Clinic/Center
  • Wentzville, MO
  • NPI 1649503772
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1231977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289952000000",
    "number": "1114164977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 COUNTRY RD",
            "address_2": "P.O. BOX 186",
            "city": "FORISTELL",
            "state": "MO",
            "postal_code": "633481722",
            "telephone_number": "636-332-6906",
            "fax_number": "636-639-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 CREEKSIDE OFFICE DRIVE",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633853290",
            "telephone_number": "636-357-0136",
            "fax_number": "636-639-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSH",
        "first_name": "URSULA",
        "middle_name": "WIESE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-15",
        "last_updated": "2010-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2007036957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI (1)",
            "identifier": "1114164977",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI (2)",
            "identifier": "1649503772",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Glenda Marie Mareschal, LCSW
• Tara Ann Margadonna, PHARMD
• Jerry L. Marks, DSW, LCSW
• Kelsi Marler, FNP
• Cassandra Marsh, LPC
• Allison Marshall, DC
• Janis O Martin, PLPC
• Michelle Renee Martin, PNP
• Nicolle Martinek
• Jacqueline Nicole Newkirk Mattingly, LPC

• Clinical Psychologist in Wentzville, MO
• Providers in Wentzville, MO by specialty
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.