Michele L Johnson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

788 Issued in OK

Practice address

1430 Terrace Dr
Tulsa, OK 74104

Phone

(918) 748-8024

Fax

(918) 748-8249

NPI assigned

May 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Physician Assistant

State licenses

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558310400000",
    "number": "1346208287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 TERRACE DR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741044626",
            "telephone_number": "918-748-8024",
            "fax_number": "918-748-8249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 TERRACE DR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "74104",
            "telephone_number": "918-748-8024",
            "fax_number": "918-748-8249"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2929 S Garnett Rd",
            "address_2": "C/O Medcenter",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741295101",
            "country_code": "US",
            "telephone_number": "918-665-1520",
            "fax_number": "405-749-4561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHELE",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-02",
        "last_updated": "2019-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100187280A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Meagan Johnson
• Megan Johnson, PT
• Memory Johnson, PT
• Mercedea Johnson
• Michael G Johnson
• Miranda Johnson, DO
• Nicole Elizabeth Johnson, DO
• Nicole Jeanette Johnson
• Patricea Johnson
• Patricia M. Johnson

• Physician Assistant in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Physician Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; 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.