Individual provider Active NPI

Sunnia Johns, MSN, FNP-C

  • Family Nurse Practitioner
  • Lawton, OK
National Provider Identifier
1609480813
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R108747 Issued in OK
Practice address
1515 NE Lawrie Tatum Rd
Lawton, OK 73507-3002
Phone
(405) 822-0286
NPI assigned
Sep 4, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R108747 OK Primary

Addresses

Primary practice location

1515 NE Lawrie Tatum Rd
Lawton, OK 73507-3002

Mailing address

4209 Stardust LN
Tuttle, OK 73089-4614
Phone (405) 822-0286

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220316001132 OK Practitioner - Nurse Practitioner 0244625952 Reassigns benefits to 1 organization
I20240603004045 TX Practitioner - Nurse Practitioner 0244625952 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R108747OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Icare Center LLC CurrentSince Dec 3, 2021 Accepting new patients
Lawton Indian Hospital CurrentSince Apr 21, 2024 Accepting new patients

Locations

404 W Main St
Davis, OK 73030
Phone (405) 391-5526

21001 SE 29th St
Harrah, OK 73045
Phone (405) 391-5526

1515 NE Lawrie Tatum Rd
Lawton, OK 73507
Phone (580) 353-0350

2903 W Britton Rd
Oklahoma City, OK 73120
Phone (405) 755-8028

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.

NPI Registry JSON

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

{
    "created_epoch": "1599177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1609480813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4209 STARDUST LN",
            "city": "TUTTLE",
            "state": "OK",
            "postal_code": "730894614",
            "telephone_number": "405-822-0286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 NE LAWRIE TATUM RD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735073002",
            "telephone_number": "405-822-0286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNS",
        "first_name": "SUNNIA",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-04",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "R108747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

Verify at the official NPI Registry.