Active NPI
Jojo Sam Johnson
- Pharmacist
- Mustang, OK
National Provider Identifier
1497529945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 20315
- Practice address
- 951 E State Highway 152
Mustang, OK 73064-5119 - Phone
- (405) 376-4525
- NPI assigned
- Nov 14, 2023
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 20315 | OK | Primary |
Addresses
Primary practice location
951 E State Highway 152
Mustang, OK 73064-5119
Mailing address
951 E State Highway 152
Mustang, OK 73064-5119
Phone (405) 376-4525
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20315 | OK | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wal-Mart Stores East LP | Past | Accepting new patients | |
| Wal-Mart Stores East, LP | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Retail Pharmacy
- Mustang, OK
- NPI 1043237159
-
- Pharmacy
- Apollo Beach, FL
- NPI 1437027208
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1699920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699920000000",
"number": "1497529945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "951 E STATE HIGHWAY 152",
"city": "MUSTANG",
"state": "OK",
"postal_code": "730645119",
"telephone_number": "405-376-4525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "951 E STATE HIGHWAY 152",
"city": "MUSTANG",
"state": "OK",
"postal_code": "730645119",
"telephone_number": "405-376-4525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAM JOHNSON",
"first_name": "JOJO",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-11-14",
"last_updated": "2023-11-14",
"certification_date": "2023-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OK",
"license": "20315",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mustang, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.