Individual provider Active NPI

Gary A Johnson, MD

  • Gynecologic Oncology Physician
  • Oklahoma City, OK
National Provider Identifier
1083682660
Registry record updated Mar 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
License
036.12058 Issued in IL
Practice address
13308 Cedar TRL
Oklahoma City, OK 73131-1801
Phone
(719) 651-3868
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecologic Oncology Physician 207VX0201X 2012029926 MO
Gynecologic Oncology Physician 207VX0201X 04-34519 KS
Gynecologic Oncology Physician 207VX0201X 036.12058 IL Primary
Gynecologic Oncology Physician 207VX0201X 18538 OK

Addresses

Primary practice location

13308 Cedar TRL
Oklahoma City, OK 73131-1801

Mailing address

13308 Cedar TRL
Oklahoma City, OK 73131-1801
Phone (719) 651-3868

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.12058ILMDGynecologic Oncology Physician
04-34519KSMDGynecologic Oncology Physician
2012029926MOMDGynecologic Oncology Physician
18538OKMDGynecologic Oncology Physician

NPI Registry JSON

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774224000000",
    "number": "1083682660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13308 CEDAR TRL",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731311801",
            "telephone_number": "719-651-3868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13308 CEDAR TRL",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731311801",
            "telephone_number": "719-651-3868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GARY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2026-03-23",
        "certification_date": "2026-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "MO",
            "license": "2012029926",
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "KS",
            "license": "04-34519",
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "IL",
            "license": "036.12058",
            "primary": true
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "OK",
            "license": "18538",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.