NPIMap

Individual provider Active NPI

Marilyn Austin-Clark

  • Family Nurse Practitioner
  • Guthrie, OK
National Provider Identifier
1164819504
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
81876 Issued in OK
Practice address
624 E Noble Ave
Guthrie, OK 73044-3411
Phone
(405) 471-4914
NPI assigned
Apr 23, 2015
Last updated
Sep 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 81876 OK Primary

Addresses

Primary practice location

624 E Noble Ave
Guthrie, OK 73044-3411

Mailing address

624 E Noble Ave
Guthrie, OK 73044-3411
Phone (405) 471-4914

Other identifiers 1

IdentifierTypeStateIssuer
12150625001972MedicaidOK

Other names 1

  • Marilyn Austin Clark Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150625001972 OK Practitioner - Nurse Practitioner 1557672904 Reassigns benefits to 2 organizations
I20240206001519 TX Practitioner - Nurse Practitioner 1557672904 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oklahoma Sleep Institute Clinic Okc LLC Osi ClinicGroup PAC ID 7113070731, 7 clinicians

Practice addresses (Care Compare)

13901 Technology Dr
Suite a
Oklahoma City, OK 73134-1052
Phone (405) 606-2727

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.12 of 100Reported as group
Quality
83.76
Promoting interoperability
100
Improvement activities
40
Cost
56.64

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Creek Nation Hospital & Clinics Current Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Jan 11, 2024 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Jan 11, 2024 Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Jan 11, 2024 Accepting new patients
Sleep Safe LLC Past Accepting new patients
Mercy Hospital Ardmore, Inc. Past Accepting new patients
Mercy Hospital Ada, Inc Past Accepting new patients

Locations

1800 E Coplin St
Okemah, OK 74859
Phone (918) 623-1424

1101 S Belmont Ave
Ste 204
Okmulgee, OK 74447
Phone (918) 756-3526

1401 Morris Dr
Okmulgee, OK 74447
Phone (918) 456-0641

900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448

10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760

Dept 1467
Tulsa, OK 74182

Interoperability endpoints

  • Direct secure messaging: marilyn.clark.1@13821.direct.athenahealth.com
  • Direct secure messaging: mclark22776@muscogeecreeknation.direct-ci.com

Organizations & group practices 8

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1164819504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 E NOBLE AVE",
            "city": "GUTHRIE",
            "state": "OK",
            "postal_code": "730443411",
            "telephone_number": "405-471-4914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 E NOBLE AVE",
            "city": "GUTHRIE",
            "state": "OK",
            "postal_code": "730443411",
            "telephone_number": "405-471-4914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AUSTIN-CLARK",
        "first_name": "MARILYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-23",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "81876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12150625001972",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARILYN",
            "last_name": "CLARK",
            "middle_name": "AUSTIN",
            "credential": "APRN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Guthrie, OK

Sources for this page

Verify at the official NPI Registry.