Active NPI
Diane Annette Robison Johnson, RD
- Registered Dietitian
- Tulsa, OK
National Provider Identifier
1063251825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2969
- Practice address
- 2139 E 21St St
Tulsa, OK 74114-1409 - Phone
- (314) 606-7090
- NPI assigned
- May 22, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2969 | OK | Primary |
Addresses
Primary practice location
2139 E 21St St
Tulsa, OK 74114-1409
Mailing address
511 W 128TH St S
Jenks, OK 74037-4410
Phone (314) 606-7090
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2969 | OK | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732147200000",
"number": "1063251825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "511 W 128TH ST S",
"city": "JENKS",
"state": "OK",
"postal_code": "740374410",
"telephone_number": "314-606-7090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2139 E 21ST ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741141409",
"telephone_number": "314-606-7090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "DIANE",
"middle_name": "ANNETTE ROBISON",
"name_prefix": "Mrs.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-22",
"last_updated": "2024-11-21",
"certification_date": "2024-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OK",
"license": "2969",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.