Conner Eugene Johnson, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

6678 Issued in OK

Practice address

1450 S Eastern Ave BLDG a
Oklahoma City, OK 73129-6035

Phone

(405) 632-6688

NPI assigned

Jun 19, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cjohnson376394@direct.ochin.org

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.

• Variety Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Oklahoma City, OK
  • NPI 1780697813
  Medicare reassignment NPD
• Variety Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Norman, OK
  • NPI 1144666769
  NPD
• Variety Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Oklahoma City, OK
  • NPI 1942045455
  NPD
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1831683101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 N GRAND BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731071818",
            "telephone_number": "405-632-6688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 S EASTERN AVE BLDG A",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731296035",
            "telephone_number": "405-632-6688"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 SW 44th St",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731093540",
            "country_code": "US",
            "telephone_number": "405-632-6688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CONNER",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-19",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OK",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "6678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Colene Johnson, FNP-BC
• Carroll Louise Johnson, ATC/L
• Cassie Lynn Johnson, APRN-CNP
• Cedrick Johnson
• Cicely Rochelle Johnson
• Cynthia Regina Johnson, LPC, BHRS
• Daisy Lynne Johnson
• Damon L Johnson, DDS
• Danielle Lynea Johnson
• Darlene G. Johnson, M.D.

• Pediatrics Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Pediatrics Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.