Jayme Johnson, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

L0070259 Issued in OK

Practice address

193461 E. County Rd
Fort Supply, OK 73841

Phone

(580) 766-2311

NPI assigned

Nov 29, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1638144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1114684966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "193461 E. COUNTY RD",
            "city": "FORT SUPPLY",
            "state": "OK",
            "postal_code": "73841",
            "telephone_number": "580-766-2311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "193461 E. COUNTY RD",
            "city": "FORT SUPPLY",
            "state": "OK",
            "postal_code": "73841",
            "telephone_number": "580-766-2311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JAYME",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-29",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OK",
            "license": "L0070259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Baylee Taylor Chance
• Fort Supply Public Schools
• Cathy Heinen
• Patrick Scott Herd, MD
• Penny Hills
• William A Mitchell, M.D
• Northwest Center for Behavioral Health
• Carrie Randall
• Chelsea Monique Ritzendollar, APRN
• Christen Lynn Schmidt, DPH

• Licensed Practical Nurse in Fort Supply, OK
• Providers in Fort Supply, OK by specialty
• Licensed Practical Nurse in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; 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.