Active NPI
Brooke Johanson
- Peer Specialist
- Tulsa, OK
National Provider Identifier
1144062431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 12 E 12TH St
Tulsa, OK 74119-2803 - Phone
- (918) 640-4011
- NPI assigned
- Jun 10, 2024
- Last updated
- Jun 10, 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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | NU | Primary |
Addresses
Primary practice location
12 E 12TH St
Tulsa, OK 74119-2803
Mailing address
4736 S Harvard Ave Apt 29
Tulsa, OK 74135-3016
Phone (918) 640-4011
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717977600000",
"number": "1144062431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4736 S HARVARD AVE APT 29",
"city": "TULSA",
"state": "OK",
"postal_code": "741353016",
"telephone_number": "918-640-4011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 E 12TH ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741192803",
"telephone_number": "918-640-4011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHANSON",
"first_name": "BROOKE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-10",
"last_updated": "2024-06-10",
"certification_date": "2024-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
- Morgan Jochum, RN
- Jamie Jocis, M.S., R.D., L.D.
- Karina Maria Johannes, PA-C
- Megan Michelle Johanning, D.O.
- Alicia Marie Johansen
- John B White, MD PC
- John D. Mose III D.D.S. P.C. (Mose Family Dentistry)
- John E Merriman, M.D. Inc.
- John F Carletti DDS Prof Corp (Carletti Dentistry & Associates)
- John H Keefe III DC PC (keefe clinic)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.