Active NPI
Pam Johnston
- Registered Dietitian
- Bethany, OK
National Provider Identifier
1083712640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1104
- Practice address
- 6800 NW 39TH Expy
Bethany, OK 73008-2513 - Phone
- (405) 789-6711
- Fax
- (405) 789-0690
- NPI assigned
- Sep 20, 2006
- 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 | 1104 | OK | Primary |
Addresses
Primary practice location
6800 NW 39TH Expy
Bethany, OK 73008-2513
Mailing address
6800 NW 39TH Expy
Bethany, OK 73008-2513
Phone (405) 789-6711
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 |
|---|---|---|---|
| 1104 | OK | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083712640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6800 NW 39TH EXPY",
"city": "BETHANY",
"state": "OK",
"postal_code": "730082513",
"telephone_number": "405-789-6711",
"fax_number": "405-789-0690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6800 NW 39TH EXPY",
"city": "BETHANY",
"state": "OK",
"postal_code": "730082513",
"telephone_number": "405-789-6711",
"fax_number": "405-789-0690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTON",
"first_name": "PAM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OK",
"license": "1104",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bethany, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.