Active NPI
Joseph Roy Johnson, DO
- Obstetrics & Gynecology Physician
- Tulsa, OK
National Provider Identifier
1457310658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 4355
- Practice address
- 717 S Houston Ave Ste 200
Tulsa, OK 74127-9005 - Phone
- (918) 586-4500
- Fax
- (918) 586-4528
- NPI assigned
- Mar 17, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 4355 | OK | Primary |
Addresses
Primary practice location
717 S Houston Ave Ste 200
Tulsa, OK 74127-9005
Mailing address
2401 Southwest Blvd
Tulsa, OK 74107-2726
Phone (918) 561-5701
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200073890A | Medicaid | OK |
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
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4355 | OK | MD | Obstetrics & Gynecology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549843200000",
"number": "1457310658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2401 SOUTHWEST BLVD",
"city": "TULSA",
"state": "OK",
"postal_code": "741072726",
"telephone_number": "918-561-5701",
"fax_number": "918-561-1173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "717 S HOUSTON AVE STE 200",
"city": "TULSA",
"state": "OK",
"postal_code": "741279005",
"telephone_number": "918-586-4500",
"fax_number": "918-586-4528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "JOSEPH",
"middle_name": "ROY",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-17",
"last_updated": "2019-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "OK",
"license": "4355",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200073890A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.