Individual provider Active NPI

Mary Claire Carbonell, APRN

  • Family Nurse Practitioner
  • Nichols Hills, OK
National Provider Identifier
1457956286
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R0100066 Issued in OK
Practice address
1121 NW 63Rd St Ste 5001
Nichols Hills, OK 73116-6504
Phone
(405) 652-0632
NPI assigned
Dec 1, 2020
Last updated
Jun 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R0100066 OK Primary
Family Nurse Practitioner 363LF0000X 1141738 TX

Addresses

Primary practice location

1121 NW 63Rd St Ste 5001
Nichols Hills, OK 73116-6504

Mailing address

PO Box 776084
Chicago, IL 60677-6084

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210408001313 OK Practitioner - Nurse Practitioner 4385051473 Reassigns benefits to 9 organizations
I20260330000126 TX Practitioner - Nurse Practitioner 4385051473 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Resource Management LLCGroup PAC ID 4082753918, 53 clinicians
Mercy Oklahoma Ambulatory Services LLCGroup PAC ID 9830447036, 43 clinicians
Health Hub Physicians IncGroup PAC ID 6709387798, 7 clinicians
Variety Care, Inc.Group PAC ID 1557260007, shared by 23 NPIs, 101 clinicians

Practice addresses (Care Compare)

1000 NW 32ND St
Newcastle, OK 73065-6334
Phone (405) 387-9325

10701 N Rockwell Ave
Oklahoma City, OK 73162-4537
Phone (405) 470-1500

111 Forest Dr
Eufaula, OK 74432-4010
Phone (800) 640-9741

1121 NW 63Rd St
Suite 5001
Nichols Hills, OK 73116-6504
Phone (405) 652-0632

1505 E Main St
Stigler, OK 74462-2914
Phone (800) 640-9741

199 Rex Ivey Rd
Terlingua, TX 79852-5060
Phone (432) 300-5175

201 W 1St St
Grandfield, OK 73546-9236
Phone (405) 632-6688

2109 S Santa Fe Ave
Moore, OK 73160-2807
Phone (405) 213-0256

3000 N Grand Blvd
Oklahoma City, OK 73107-1818
Phone (405) 632-6688

301 S Mustang Rd
Yukon, OK 73099-6704
Phone (405) 324-1911

5300 SE 29TH St
Oklahoma City, OK 73115-4702
Phone (405) 835-2770

806 Hwy 2 N
Wilburton, OK 74578-3625
Phone (800) 640-9741

9917 SE 15TH St
Midwest City, OK 73130-5504
Phone (405) 622-2070

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1141738TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tulsa Emergency Medical Center Inc CurrentSince Aug 12, 2025 Accepting new patients
Medical Resource Management, LLC CurrentSince Aug 12, 2025 Accepting new patients
Integris Health Allset Urgent Care LLC CurrentSince Feb 8, 2024 Accepting new patients
Variety Care, Inc. CurrentSince Oct 9, 2023 Accepting new patients
The Physicians Group LLC CurrentSince Sep 1, 2021 Accepting new patients
Oak Street Health Physicians Group of Oklahoma, LLC Family CurrentSince May 16, 2022 Accepting new patients
Applebaum Physiatry PLLC Family CurrentSince Jun 1, 2025 Accepting new patients
Comprehensive Rehab Consultants PLLC Family CurrentSince Jan 1, 2023 Accepting new patients
Variety Care, Inc. Current Accepting new patients
Stigler Health and Wellness Center Inc CurrentSince Apr 29, 2024 Accepting new patients
Mercy Oklahoma Ambulatory Services LLC CurrentSince Dec 1, 2025 Accepting new patients
Variety Care, Inc. CurrentSince Oct 9, 2023 Accepting new patients

Locations

415 W Golf Rd
Ste 26
Arlington Hts, IL 60005

1380 W Covell Rd
Ste 132
Edmond, OK 73003
Phone (405) 279-9637

3224 S Broadway
Ste 112
Edmond, OK 73013
Phone (405) 427-4941

1401 N Garland Rd
Enid, OK 73703
Phone (580) 234-2526

1000 S Broadway
Hobart, OK 73651

7521 SE 15th St
Midwest City, OK 73110
Phone (405) 453-8004

1121 NW 63rd St
Ste 5001
Nichols Hills, OK 73116
Phone (405) 652-0632

3075 Classen Blvd
Norman, OK 73071
Phone (405) 552-0155

3075 Classen Blvd
Ste 226
Norman, OK 73071

10021 S Western Ave
Oklahoma City, OK 73139
Phone (405) 692-9300

10701 N Rockwell Ave
Oklahoma City, OK 73162
Phone (405) 470-1500

10740 S May Ave
Ste 113
Oklahoma City, OK 73170
Phone (405) 427-4942

1140 N Hudson Ave
Oklahoma City, OK 73103
Phone (405) 272-0660

3000 N Grand Blvd
Oklahoma City, OK 73107
Phone 405632668810209

5401 N Pennsylvania Ave
Oklahoma City, OK 73112
Phone (405) 427-4944

5725 S Ross Ave
Oklahoma City, OK 73119
Phone (405) 685-4791

6900 NW 122nd St
Ste 105
Oklahoma City, OK 73142
Phone (405) 427-4943

959 SW 107th St
Oklahoma City, OK 73170
Phone (405) 703-3400

1505 E Main St
Stigler, OK 74462
Phone (800) 640-9741

1538 N Lewis Ave
Tulsa, OK 74110
Phone (918) 400-7001

2929 S Garnett Rd
Tulsa, OK 74129
Phone (918) 665-1520

1701 Garth Brooks Blvd
Yukon, OK 73099
Phone (815) 846-0871

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: mary.carbonellfnp.p10@direct.nextcare.nextgenshare.com
  • Direct secure messaging: mary.carbonellfnp.p8@direct.nextcare.nextgenshare.com
  • Direct secure messaging: mcarbonell670224@direct.ochin.org
  • Direct secure messaging: mcarbonell728020@direct.ochin.org

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1606780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781049600000",
    "number": "1457956286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776084",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 NW 63RD ST STE 5001",
            "city": "NICHOLS HILLS",
            "state": "OK",
            "postal_code": "731166504",
            "telephone_number": "405-652-0632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBONELL",
        "first_name": "MARY CLAIRE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-01",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R0100066",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1141738",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nichols Hills, OK

Sources for this page

Verify at the official NPI Registry.