Active NPI
Tabitha Johnson
- Technician/Technologist
- Anderson, SC
National Provider Identifier
1063943231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Technician/Technologist
- Practice address
- 3215 Martin Luther King Jr Blvd
Suite O
Anderson, SC 29625-1715 - Phone
- (864) 540-8404
- Fax
- (864) 540-8406
- NPI assigned
- Mar 21, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Technician/Technologist | 156F00000X | Primary |
Addresses
Primary practice location
3215 Martin Luther King Jr Blvd
Suite O
Anderson, SC 29625-1715
Mailing address
3212 Martin Luther King Jr Boulevard
Suite O
Anderson, SC 29625
Phone (864) 540-8404
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Innovative Vision Therapy Center | Past | Accepting new patients |
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.
-
- Vision Therapy Optometrist
- Anderson, SC
- NPI 1265943450
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490054400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490054400000",
"number": "1063943231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3212 MARTIN LUTHER KING JR BOULEVARD",
"address_2": "SUITE O",
"city": "ANDERSON",
"state": "SC",
"postal_code": "29625",
"telephone_number": "864-540-8404",
"fax_number": "864-540-8406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3215 MARTIN LUTHER KING JR BLVD",
"address_2": "SUITE O",
"city": "ANDERSON",
"state": "SC",
"postal_code": "296251715",
"telephone_number": "864-540-8404",
"fax_number": "864-540-8406"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "TABITHA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-03-21",
"last_updated": "2017-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "156F00000X",
"taxonomy_group": "",
"desc": "Technician/Technologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anderson, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.