Marissa Buckner, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

99136 Issued in OK

Practice address

2900 S Telephone Rd
Suite 250
Moore, OK 73160-2968

Phone

(405) 237-7500

NPI assigned

Jan 28, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Emergency Physicians of Mid-America, P.C.

  • Emergency Medicine Physician
  • Oklahoma City, OK
  • NPI 1063825297

  OK

  Medicare reassignment NPD
• Oklahoma Emergency Services PC

  • Emergency Medicine Physician
  • Lawton, OK
  • NPI 1114239795

  OK

  Medicare reassignment NPD
• SSM Health Care of Oklahoma, Inc.

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1366545311
  NPD (past)

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

{
    "created_epoch": "1422403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492646400000",
    "number": "1487044541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10528 APPLEGROVE CIR",
            "city": "MIDWEST CITY",
            "state": "OK",
            "postal_code": "731307060",
            "telephone_number": "405-237-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 S TELEPHONE RD",
            "address_2": "SUITE 250",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731602968",
            "telephone_number": "405-237-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKNER",
        "first_name": "MARISSA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-28",
        "last_updated": "2017-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "99136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Misty Broyles, PHARM.D.
• Shay Bruce
• James P. Bruner, MA, LPC
• Rachel Elizabeth Bryant, OTR/L
• Kathryn Buchanan
• Robert Dwain Bundrick, L.P.C. (CANDIDATE)
• Kylie Alexis Burch
• Sara Burchett, MASSAGE THERAPIST
• Eric Burd Jr.
• Elizabeth Lorayne Burkhart, O.D.

• All providers in Moore, OK
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.