Individual provider Active NPI

Mariah Nichole Thomas, APRN-CNP

  • Primary Care Nurse Practitioner
  • Ardmore, OK
National Provider Identifier
1235871336
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
F05220327 Issued in OK
Practice address
830 16TH Ave NW
Ardmore, OK 73401-1818
Phone
(580) 226-5120
Fax
(580) 223-1003
NPI assigned
Apr 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X F05220327 OK Primary

Addresses

Primary practice location

830 16TH Ave NW
Ardmore, OK 73401-1818

Mailing address

33386 N County Road 3170
Elmore City, OK 73433-9084
Phone (580) 371-6922

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220826000220 OK Practitioner - Nurse Practitioner 6901289115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oklahoma Integrated Care PLCGroup PAC ID 5193113751, 9 clinicians

Practice addresses (Care Compare)

830 16TH Ave NW
Ardmore, OK 73401-1818
Phone (580) 226-5120

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F05220327OKMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma Integrated Care PLC CurrentSince Jun 2, 2025 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

1013 15th Ave NW
Ardmore, OK 73401
Phone (580) 238-4277

830 16th Ave NW
Ardmore, OK 73401
Phone (580) 226-5120

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.

Hospital & facility affiliations 3

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": "1649462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1235871336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33386 N COUNTY ROAD 3170",
            "city": "ELMORE CITY",
            "state": "OK",
            "postal_code": "734339084",
            "telephone_number": "580-371-6922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 16TH AVE NW",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734011818",
            "telephone_number": "580-226-5120",
            "fax_number": "580-223-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MARIAH",
        "middle_name": "NICHOLE",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-09",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OK",
            "license": "F05220327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ardmore, OK

Sources for this page

Verify at the official NPI Registry.