Individual provider Active NPI

Johnny Dakota Hutchison, MD

  • Internal Medicine Physician
  • Oklahoma City, OK
National Provider Identifier
1649009853
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
45646 Issued in OK
Practice address
800 Stanton L Young Blvd
Oklahoma City, OK 73104-5018
Phone
(405) 271-5963
NPI assigned
Jul 29, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 45646 OK Primary

Addresses

Primary practice location

800 Stanton L Young Blvd
Oklahoma City, OK 73104-5018

Mailing address

105 Keystone LN
Maumelle, AR 72113-5958
Phone (479) 856-8730

Other practice location 1

4301 W Markham St
Little Rock, AR 72205-7101
Phone (501) 686-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250801002714 OK Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 3274041132

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
45646OKMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1722211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747958400000",
    "number": "1649009853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 KEYSTONE LN",
            "city": "MAUMELLE",
            "state": "AR",
            "postal_code": "721135958",
            "telephone_number": "479-856-8730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 STANTON L YOUNG BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731045018",
            "telephone_number": "405-271-5963"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4301 W Markham St",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722057101",
            "country_code": "US",
            "telephone_number": "501-686-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUTCHISON",
        "first_name": "JOHNNY",
        "middle_name": "DAKOTA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-29",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "45646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.