Individual provider Active NPI

Marisa Mae Thompson, MA, OTR/L

  • Occupational Therapist
  • Fort Worth, TX
National Provider Identifier
1780954339
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
124389 Issued in TX
Practice address
3840 Hulen St Ste 100
Fort Worth, TX 76107-7269
Phone
(817) 569-4300
NPI assigned
Jan 12, 2012
Last updated
Apr 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 124389 TX Primary
Pediatric Occupational Therapist 225XP0200X 3297 CO
Pediatric Occupational Therapist 225XP0200X 6152 MT

Addresses

Primary practice location

3840 Hulen St Ste 100
Fort Worth, TX 76107-7269

Mailing address

9305 Sunset LN
Oak Point, TX 75068-2315
Phone (507) 202-3227

Other practice location 1

9305 Sunset Ln
Oak Point, TX 75068-2315
Phone (507) 202-3227

Other names 1

  • Marisa Mae Grunklee Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
124389TXMDOccupational Therapist
3297COMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas County Mental Health & Mental Retardation Center CurrentSince Aug 8, 2022 Accepting new patients

Locations

1881 Sylvan Ave
Ste 150
Dallas, TX 75208
Phone (214) 331-0107

1881 Sylvan Ave
Ste 200
Dallas, TX 75208
Phone (214) 331-0107

Organizations & group practices 1

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": "1326326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1780954339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9305 SUNSET LN",
            "city": "OAK POINT",
            "state": "TX",
            "postal_code": "750682315",
            "telephone_number": "507-202-3227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3840 HULEN ST STE 100",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761077269",
            "telephone_number": "817-569-4300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9305 Sunset Ln",
            "address_purpose": "LOCATION",
            "city": "Oak Point",
            "state": "TX",
            "postal_code": "750682315",
            "country_code": "US",
            "telephone_number": "507-202-3227",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "MARISA",
        "middle_name": "MAE",
        "name_prefix": "Mrs.",
        "credential": "MA, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-12",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "124389",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CO",
            "license": "3297",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MT",
            "license": "6152",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISA",
            "last_name": "GRUNKLEE",
            "middle_name": "MAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.