Individual provider Active NPI

Angela D Johnston, PA-C

  • Physician Assistant
  • Enid, OK
National Provider Identifier
1215187885
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5249 Issued in OK
Practice address
3201 N Van Buren St
Enid, OK 73703-1812
Phone
(580) 234-7070
Fax
(580) 234-9544
NPI assigned
Sep 19, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5249 OK Primary

Addresses

Primary practice location

3201 N Van Buren St
Enid, OK 73703-1812

Mailing address

PO Box 3494
Enid, OK 73702-3494
Phone (580) 234-7070

Other identifiers 1

IdentifierTypeStateIssuer
200513210AMedicaidOK

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5249OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Enid Clinic Inc CurrentSince Mar 31, 2024 Accepting new patients

Locations

3201 N Van Buren St
Ste 300
Enid, OK 73703
Phone (580) 233-5553

Interoperability endpoints

  • Direct secure messaging: angelajohnston@rma.allscriptsdirect.net

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1221782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1215187885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3494",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737023494",
            "telephone_number": "580-234-7070",
            "fax_number": "580-234-9544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 N VAN BUREN ST",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737031812",
            "telephone_number": "580-234-7070",
            "fax_number": "580-234-9544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "ANGELA",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-19",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "5249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200513210A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enid, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; 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.