Individual provider Active NPI

Adrian Johnson

  • Rehabilitation Psychologist
  • Oklahoma City, OK
National Provider Identifier
1972802742
Registry record updated Mar 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PsychologistTaxonomy code 103TR0400X
Practice address
4112 Coletta Dr
Oklahoma City, OK 73120-8342
Phone
(862) 215-7474
NPI assigned
Mar 19, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Psychologist 103TR0400X Primary

Addresses

Primary practice location

4112 Coletta Dr
Oklahoma City, OK 73120-8342

Mailing address

4112 Coletta Dr
Oklahoma City, OK 73120-8342
Phone (862) 215-7474

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

NPI Registry JSON

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

{
    "created_epoch": "1300492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300492800000",
    "number": "1972802742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4112 COLETTA DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208342",
            "telephone_number": "862-215-7474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4112 COLETTA DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208342",
            "telephone_number": "862-215-7474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ADRIAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-19",
        "last_updated": "2011-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2011; 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.