Individual provider Active NPI

Marisha Dawson

  • Psychiatric/Mental Health Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1881372159
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
214871 Issued in OK
Practice address
4400 N Lincoln Blvd
Oklahoma City, OK 73105-5108
Phone
(405) 424-7711
NPI assigned
Jul 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 214871 OK
Registered Nurse 163W00000X R0088014 OK
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 214871 OK Primary

Addresses

Primary practice location

4400 N Lincoln Blvd
Oklahoma City, OK 73105-5108

Mailing address

1416 NW 105TH St
Oklahoma City, OK 73114-5116

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
I20240111000985 OK Practitioner - Nurse Practitioner 1052762341 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oakwood Springs Physician Group LLCGroup PAC ID 1658658026, 16 clinicians
Oklahoma Mental Health CouncilGroup PAC ID 3173514387, 69 clinicians

Practice addresses (Care Compare)

13101 Memorial Springs CT
Oklahoma City, OK 73114-2226
Phone (405) 438-3000

4130 N Lincoln Blvd
Red Rock Behavioral Health Services
Oklahoma City, OK 73105-5209
Phone (405) 424-7711

4400 N Lincoln Blvd
Oklahoma City, OK 73105-5104

4420 N Lincon Blvd
Red Rock Behavioral
Oklahoma City, OK 73105-5104
Phone (405) 424-7711

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0088014OKMDRegistered Nurse
214871OKMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oakwood Springs Physician Group LLC CurrentSince Dec 26, 2023 Accepting new patients
Resilient Mindfulness Clinic Current Accepting new patients
Oklahoma Mental Health Council CurrentSince Mar 1, 2025 Accepting new patients
Oklahoma Mental Health Council CurrentSince Mar 1, 2025 Accepting new patients
Oakwood Springs, LLC PastSince Dec 26, 2023 Accepting new patients

Locations

13101 Memorial Springs Ct
Oklahoma City, OK 73114
Phone (405) 438-3000

4400 N Lincoln Blvd
Oklahoma City, OK 73105

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1688688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1881372159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 NW 105TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731145116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 N LINCOLN BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731055108",
            "telephone_number": "405-424-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "MARISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-07",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OK",
            "license": "214871",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "R0088014",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OK",
            "license": "214871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.