Jeffery Blake Johnson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2693 Issued in AR

Practice address

3805 West 28TH
Pine Bluff, AR 71603

Phone

(870) 536-4100

Fax

(870) 536-9020

NPI assigned

Jul 14, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AR, TN2 enrollments

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 2

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 2010

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dr. Perry Lee Amerine, PA

  • Optometrist
  • Little Rock, AR
  • NPI 1427370022
  Medicare reassignment NPD
• Presley Eye Care PLLC

  • Optometrist
  • North Little Rock, AR
  • NPI 1740004175
  Medicare reassignment NPD
• Politzer and Durocher PLC

  • Optometrist
  • Nashville, TN
  • NPI 1396738720
  Medicare reassignment NPD
• Illinois Retina Surgery LTD

  • Ophthalmic Technician/Technologist
  • Swansea, IL
  • NPI 1255374559
  NPD (past)
• JFJ Eyecare LTD

  • Optometrist
  • Swansea, IL
  • NPI 1295778587
  NPD (past)

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

{
    "created_epoch": "1279065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394150400000",
    "number": "1013229442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3805 WEST 28TH",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "71603",
            "telephone_number": "870-536-4100",
            "fax_number": "870-536-9020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805 WEST 28TH",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "71603",
            "telephone_number": "870-536-4100",
            "fax_number": "870-536-9020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JEFFERY",
        "middle_name": "BLAKE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-14",
        "last_updated": "2014-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2693",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.010370",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John E Harris MD PA
• John O Lytle MD PA
• Bethanie Johnson
• Chiquita Johnson, BA
• Donna Johnson
• Kamelia Johnson
• Kimberlee D Johnson, LSW
• Kimiara Johnson
• Leslie Johnson
• Lori Johnson, SLP

• Optometrist in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Optometrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.