Individual provider Active NPI

Jay C. Johnston, M.D.

  • Specialist
  • Oklahoma City, OK
National Provider Identifier
1740217082
Registry record updated Feb 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
8645 Issued in OK
Practice address
4200 W Memorial Rd
Ste 101
Oklahoma City, OK 73120-9350
Phone
(405) 749-4280
Fax
(405) 749-4281
NPI assigned
Jun 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 8645 OK Primary

Addresses

Primary practice location

4200 W Memorial Rd
Ste 101
Oklahoma City, OK 73120-9350

Mailing address

4200 W Memorial Rd
Ste 101
Oklahoma City, OK 73120-9350
Phone (405) 749-4280

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
I20110915000819 OK Practitioner - Ophthalmology 3678744034 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jay C. Johnston, M. D., Inc Specialist CurrentSince Feb 4, 1997 Accepting new patients

Locations

4200 W Memorial Rd
Ste 101
Oklahoma City, OK 73120
Phone (405) 749-4280

Organizations & group practices 1

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": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456444800000",
    "number": "1740217082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 W MEMORIAL RD",
            "address_2": "STE 101",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731209350",
            "telephone_number": "405-749-4280",
            "fax_number": "405-749-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 W MEMORIAL RD",
            "address_2": "STE 101",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731209350",
            "telephone_number": "405-749-4280",
            "fax_number": "405-749-4281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "JAY",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2016-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OK",
            "license": "8645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.