Individual provider Active NPI

Desha Renee Johnson, PRSS

  • Peer Specialist
  • Sand Springs, OK
National Provider Identifier
1336668805
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
401 E Broadway CT Ste E
Sand Springs, OK 74063-7931
Phone
(918) 245-5565
NPI assigned
Sep 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X Primary

Addresses

Primary practice location

401 E Broadway CT Ste E
Sand Springs, OK 74063-7931

Mailing address

6333 E Skelly Dr
Tulsa, OK 74135-6106
Phone (918) 565-4093

Other practice location 1

6333 E Skelly Dr
Tulsa, OK 74135-6106
Phone (918) 565-4093

Other practice location 2

2325 S Harvard Ave
Tulsa, OK 74114-3300
Phone (918) 712-4301

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

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling & Recovery Services of Oklahoma, Inc. PastSince Jan 26, 2025 Accepting new patients

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": "1505433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1336668805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6333 E SKELLY DR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741356106",
            "telephone_number": "918-565-4093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E BROADWAY CT STE E",
            "city": "SAND SPRINGS",
            "state": "OK",
            "postal_code": "740637931",
            "telephone_number": "918-245-5565"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6333 E Skelly Dr",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741356106",
            "country_code": "US",
            "telephone_number": "918-565-4093",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2325 S Harvard Ave",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741143300",
            "country_code": "US",
            "telephone_number": "918-712-4301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DESHA",
        "middle_name": "RENEE",
        "credential": "PRSS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-15",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sand Springs, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 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.