Active NPI
Amelia M Johnson, DPO
- Optician
- Sparta, TN
National Provider Identifier
1023099512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- DPO1192
- Practice address
- 25 N Main St
Suite a
Sparta, TN 38583-2055 - Phone
- (931) 836-2235
- Fax
- (931) 836-3036
- NPI assigned
- Nov 10, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | DPO1192 | TN | Primary |
Addresses
Primary practice location
25 N Main St
Suite a
Sparta, TN 38583-2055
Mailing address
25 N Main St
Suite a
Sparta, TN 38583-2055
Phone (931) 836-2235
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4073352 | Other | TN | BLUE CROSS BLUE SHIELD |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DPO1192 | TN | MD | Optician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1023099512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 N MAIN ST",
"address_2": "SUITE A",
"city": "SPARTA",
"state": "TN",
"postal_code": "385832055",
"telephone_number": "931-836-2235",
"fax_number": "931-836-3036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 N MAIN ST",
"address_2": "SUITE A",
"city": "SPARTA",
"state": "TN",
"postal_code": "385832055",
"telephone_number": "931-836-2235",
"fax_number": "931-836-3036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "AMELIA",
"middle_name": "M",
"credential": "DPO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-10",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "TN",
"license": "DPO1192",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "4073352",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sparta, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.