Gabriel Blake Johnson

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

214 N Bliss Ave
Tahlequah, OK 74464-2520

Phone

(539) 234-3785

NPI assigned

Dec 28, 2023

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1703721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1962271155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 N BLISS AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744642520",
            "telephone_number": "539-234-3785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 N BLISS AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744642520",
            "telephone_number": "539-234-3785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GABRIEL",
        "middle_name": "BLAKE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-28",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Sue Jennings, M.D.
• Natalie Theresa Johns, PT, DPT
• Amber Nicole Johnson
• Dawn Johnson
• Debra Lee Johnson, CM
• Jennifer Cherokee Nicole Johnson
• Kenneth Johnson
• Robi Godfrey Johnson
• Sarah Johnson, HEALTH EDUCATOR
• Alison Jones, PA-C

• Peer Specialist in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Peer Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2023; 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.