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Deactivated NPI 1285153155 Deactivated / Inactive NPI Male Practitioner

Johnny Dale Gilmore

Peer Specialist • Durant, OK

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Johnny Gilmore has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 12, 2017
NPI Deactivation Date March 06, 2025
Total Practice Duration ~8 Years of Practice (2017 – 2025)

Professional Overview & Biography Verified Profile Summary

Johnny Gilmore was a registered Peer Specialist practicing in Durant, OK. Throughout an active medical career spanning 8 years, Johnny Gilmore provided care at the practice location at 1315 W TEXAS ST until profile deactivation on 2025-03-06.

Practice Location & Contact Primary Location

Practice Address

1315 W Texas St

Durant, OK 747015749

Telephone 5802809883

Specialty Benchmarks & Practice Insights

Comparative analytics for Peer Specialist in Durant, OK

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
53 Specialists

Practicing in Durant, OK (5280 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Peer Specialist Primary Specialty

NUCC Taxonomy Code: 175T00000X

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated March 06, 2025

Record deactivated on March 06, 2025

NPI Profile Active September 19, 2017

NPI status registered as active in NPPES database

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Updated Practice Location September 19, 2017

Registered at 1315 W TEXAS ST, DURANT, OK 747015749 (Tel: 5802809883)

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Updated Business Mailing Address September 19, 2017

Registered at 1315 W TEXAS ST, DURANT, OK 747015749

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Provider Name / Credentials Updated September 19, 2017

Recorded as JOHNNY GILMORE

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Medical Taxonomy / Specialty Registered (Primary Specialty) September 19, 2017

Peer Specialist

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Initial NPI Registration & Enumeration September 12, 2017

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1285153155
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 12, 2017
Last Update: September 19, 2017
Deactivation Date: March 06, 2025

Mailing Address

1315 W Texas St

Durant, OK 747015749

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.