Stacy Ellen Johns

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

433 W Broadway St
Muskogee, OK 74401-6614

Phone

(918) 687-7064

NPI assigned

Mar 3, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Creoks Mental Health Services

  • Family Medicine Physician
  • Tulsa, OK
  • NPI 1710583372
  NPD (past)

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

{
    "created_epoch": "1583193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1649804337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 S 29TH ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744015305",
            "telephone_number": "918-685-0472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 W BROADWAY ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744016614",
            "telephone_number": "918-687-7064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNS",
        "first_name": "STACY",
        "middle_name": "ELLEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-03",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John V Tedesco DO PA
• Dusti Dawn Johns, MSW, LCSW
• Jacqueline Annette Johns
• Jenny Lu Johns, O.D.
• Ruby Johns
• Johnson Associates Systems Inc.
• Corderoe Edwin Johnson Sr.
• Earline Phyllis Johnson, RN
• Lenox Dewayne Johnson
• Linda Rochelle Johnson

• Case Manager/Care Coordinator in Muskogee, OK
• Providers in Muskogee, OK by specialty
• Case Manager/Care Coordinator in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.