Individual provider Active NPI

Jennifer P Johnson, OD

  • Optometrist
  • Olathe, KS
National Provider Identifier
1003881863
Registry record updated Oct 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1464 Issued in KS
Practice address
21020 W 151St St
Olathe, KS 66061-7200
Phone
(913) 829-5511
Fax
(913) 829-5571
NPI assigned
Feb 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1464 KS Primary
Optometrist 152W00000X T03242 MO

Addresses

Primary practice location

21020 W 151St St
Olathe, KS 66061-7200

Mailing address

PO Box 219241
Kansas City, MO 64121-9241
Phone (913) 829-5511

Other identifiers 1

IdentifierTypeStateIssuer
410039582OtherKSRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100908000035 KS Practitioner - Optometry 1850415209 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Milton B Grin MD PAGroup PAC ID 3870493752, 11 clinicians

Practice addresses (Care Compare)

21020 W 151St St
Grin Eye Care
Olathe, KS 66061-7200
Phone (913) 829-5511

Merit-based Incentive Payment System (MIPS)

Final score
93.14 of 100Reported as group
Quality
100
Improvement activities
40
Cost
77.15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1464KSMDOptometrist
T03242MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Milton B Grin MD PA CurrentSince Oct 1, 2000 Accepting new patients

Locations

13400 Briar Dr
Ste C
Leawood, KS 66209
Phone (913) 829-5511

21020 W 151st St
Olathe, KS 66061
Phone (913) 829-3283

Networks

  • devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
  • devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
  • devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9

Organizations & group practices 1

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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287446400000",
    "number": "1003881863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 219241",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641219241",
            "telephone_number": "913-829-5511",
            "fax_number": "913-829-5571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21020 W 151ST ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660617200",
            "telephone_number": "913-829-5511",
            "fax_number": "913-829-5571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JENNIFER",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-22",
        "last_updated": "2010-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1464",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T03242",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410039582",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olathe, KS

Sources for this page

Verify at the official NPI Registry.