Individual provider Active NPI

Sydnie Marie Johnson

  • Pharmacist
  • Tulsa, OK
National Provider Identifier
1922501147
Registry record updated Mar 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
17039 Issued in OK
Practice address
10018 S Yale Ave
Tulsa, OK 74137-6016
Phone
(918) 298-2467
NPI assigned
Mar 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 17039 OK Primary

Addresses

Primary practice location

10018 S Yale Ave
Tulsa, OK 74137-6016

Mailing address

10018 S Yale Ave
Tulsa, OK 74137-6016
Phone (918) 298-2467

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
17039OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients

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": "1520985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520985600000",
    "number": "1922501147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10018 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741376016",
            "telephone_number": "918-298-2467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10018 S YALE AVE",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741376016",
            "telephone_number": "918-298-2467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SYDNIE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-14",
        "last_updated": "2018-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "17039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2018; 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.