Active NPI
Marquita Renee Wilson
- Counselor
- Tulsa, OK
National Provider Identifier
1154672780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 1 W 36TH St N
Tulsa, OK 74106-1700 - Phone
- (918) 636-4165
- NPI assigned
- Sep 22, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
1 W 36TH St N
Tulsa, OK 74106-1700
Mailing address
2417 E 48TH St N
Tulsa, OK 74130-2017
Phone (918) 636-4165
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200287120A | Medicaid | OK |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411430400000",
"number": "1154672780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2417 E 48TH ST N",
"city": "TULSA",
"state": "OK",
"postal_code": "741302017",
"telephone_number": "918-636-4165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 W 36TH ST N",
"city": "TULSA",
"state": "OK",
"postal_code": "741061700",
"telephone_number": "918-636-4165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "MARQUITA",
"middle_name": "RENEE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-09-22",
"last_updated": "2014-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200287120A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.