Channel Johnson, APRN, FNP, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R0100572 Issued in OK

Practice address

1728 S Carson Ave
Tulsa, OK 74119-4610

Phone

(918) 932-8266

Fax

(918) 932-8244

NPI assigned

Jun 11, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Victory Grace Healing Mental Health Services, LLC

  • Psychiatry Physician
  • Tulsa, OK
  • NPI 1790504645
  NPD Authorized official

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

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1225653512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1728 S CARSON AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741194610",
            "telephone_number": "918-932-8266",
            "fax_number": "918-932-8244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1728 S CARSON AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741194610",
            "telephone_number": "918-932-8266",
            "fax_number": "918-932-8244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6400 S Lewis Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741361019",
            "country_code": "US",
            "telephone_number": "405-378-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHANNEL",
        "name_prefix": "Miss",
        "credential": "APRN, FNP, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-11",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OK",
            "license": "R0100572",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "100572",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OK",
            "license": "R0100572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Michelle Johnson
• Cardell Johnson
• Carla Johnson
• Chad Barrett Johnson, M.D., M.B.A.
• Chad Vernon Johnson, PHD
• Chante Johnson
• Charles Johnson, R.P.A.
• Cherie D. Johnson
• Clarence Michael Johnson, D.O.
• Cornelius Johnson, LCSW

• Psychiatric/Mental Health Nurse Practitioner in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.