Individual provider Active NPI

Alyssa Marra, APRN, FNP-C

  • Family Nurse Practitioner
  • Lawton, OK
National Provider Identifier
1932805934
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
211636 Issued in OK
Practice address
102 NW 31St St
Lawton, OK 73505-6100
Phone
(580) 353-6790
NPI assigned
Feb 1, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 211636 OK Primary

Addresses

Primary practice location

102 NW 31St St
Lawton, OK 73505-6100

Mailing address

4454 NW Wolfcreek Blvd
Lawton, OK 73505-4919
Phone (580) 678-4600

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
I20230331001429 OK Practitioner - Nurse Practitioner 9133594385 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
Comanche County Healthcare CorporationGroup PAC ID 0749192433, 125 clinicians

Practice addresses (Care Compare)

102 NW 31St St
Lawton, OK 73505-6100
Phone (580) 353-6790

Hospital & facility affiliations

  • Memorial Health Hospital, Lawton, OK, CCN 370056

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Comanche County Healthcare Corporation CurrentSince Mar 27, 2023 Accepting new patients
Comanche County Healthcare Corporation Multi-Specialty CurrentSince Mar 27, 2023 Accepting new patients
Jackson County Memorial Hospital Authority Multi-Specialty Past Accepting new patients
Comanche County Healthcare Multi-Specialty Past Accepting new patients
Comanche County Hospital Authority Multi-Specialty Past Accepting new patients

Locations

3201 W Gore Blvd
Ste 201
Lawton, OK 73505
Phone (580) 357-2261

3401 W Gore Blvd
Lawton, OK 73505
Phone (580) 483-5207

102 NW 31st St
Lawton, OK 73505
Phone (580) 353-6790

3201 W Gore Blvd
Ste 300
Lawton, OK 73505
Phone (580) 248-5255

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.

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": "1675209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1932805934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4454 NW WOLFCREEK BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735054919",
            "telephone_number": "580-678-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 NW 31ST ST",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056100",
            "telephone_number": "580-353-6790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRA",
        "first_name": "ALYSSA",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-01",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "211636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

Verify at the official NPI Registry.