Individual provider Active NPI

Dennis Andrew Marikis, PHD

  • Psychologist
  • Mansfield, OH
National Provider Identifier
1184707986
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3253 Issued in OH
Practice address
788 Lexington Ave
Mansfield, OH 44907
Phone
(419) 756-2828
Fax
(417) 753-9913
NPI assigned
Oct 23, 2006
Last updated
Jul 3, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3253 OH Primary

Addresses

Primary practice location

788 Lexington Ave
Mansfield, OH 44907

Mailing address

102 E Gambier St
Mount Vernon, OH 43050
Phone (740) 392-5416

Other identifiers 1

IdentifierTypeStateIssuer
0500916MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20120425000600 OH Practitioner - Clinical Psychologist 3072575901 Practice locations: Mount Vernon, OH; Mansfield, OH

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Ohio State University College of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

788 Lexington Ave
Mansfield, OH 44907-1921
Phone (419) 756-2828

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
New Way Counseling LLC Past Accepting new patients
Physical Therapy Services of Mt PastSince Jul 1, 2004 Accepting new patients
Greg Frankenfield, Lisw, LLC Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215043200000",
    "number": "1184707986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 E GAMBIER ST",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "43050",
            "telephone_number": "740-392-5416",
            "fax_number": "740-392-3742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "788 LEXINGTON AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "44907",
            "telephone_number": "419-756-2828",
            "fax_number": "417-753-9913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIKIS",
        "first_name": "DENNIS",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2008-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "3253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0500916",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

Verify at the official NPI Registry.