DR. MARILYNN HOLMAN (MD) – Psychiatry Physician, NPI 1538589023

DR. MARILYNN HOLMAN (MD) is a healthcare provider. based in Grand coulee, Washington. specializing in PSYCHIATRY. They hold the professional credentials MD. They hold a License No. MD60775255 (WA). The NPI Number for DR. MARILYNN HOLMAN (MD) is 1538589023

Main info

Female
12 Years Of Experience
Accepts Medicare Assignment
Name
DR. MARILYNN HOLMAN (MD)
NPI
1538589023
Phone
(509) 633-1753
Address
411 FORTUYN RD
Enumeration Date
23 April 2014
Last Update Date
10 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5804363980
Graduation Year
2014 (12 years ago)
PAC ID
7618266610
Group Practice PAC ID
8426957523
Professional Enrollment ID
I20220216001844
Address ID
OK748203439AD1921XDRXX300
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:12State licenses:1Digital endpointsOther names

710 PSYCHIATRY in WA

Provider Addresses for DR. MARILYNN HOLMAN (MD)

  • 411 FORTUYN RD

    GRAND COULEE, WA 991338718

    Phone: (509) 633-1753

    Fax: (509) 633-1933

    Type: Mailing

  • 1925 WARRIOR WAY

    ADA, OK 748203491

    Phone: (580) 421-4570

    Fax: (580) 421-6283

    Type: Mailing

  • 1921 STONECIPHER DR

    ADA, OK 748203439

    Phone: (580) 436-3980

    Fax: (580) 421-6283

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-02-16

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220216001844IPsychiatryTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 99133)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8426957523View full group profile

Reviews

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Frequently asked questions

How is DR. MARILYNN HOLMAN (MD) identified in CMS data?
CMS-hosted NPPES data lists DR. MARILYNN HOLMAN (MD) with NPI 1538589023.
Does the file indicate DR. MARILYNN HOLMAN (MD) is practicing under active NPI?
Directory data currently reports DR. MARILYNN HOLMAN (MD) as active.
What taxonomy line describes DR. MARILYNN HOLMAN (MD)?
For research purposes, treat DR. MARILYNN HOLMAN (MD) as Psychiatry Physician in this dataset. Clinical services aligned with this taxonomy classification.
Does DR. MARILYNN HOLMAN (MD) list a practice location?
Patients near Grand Coulee, Washington may find DR. MARILYNN HOLMAN (MD) in results; validate coverage separately.
How many locations tie to this NPI?
4 practice locations appear in the available data.

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