Individual provider Active NPI

Angela P. Johnson, O.D.

  • Optometrist
  • Murfreesboro, TN
National Provider Identifier
1073597670
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1993 Issued in TN
Practice address
1524 Beasie Rd
Murfreesboro, TN 37128-2945
Phone
(615) 439-2646
NPI assigned
Dec 6, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1993 TN Primary
Optometrist 152W00000X 2955 MN

Addresses

Primary practice location

1524 Beasie Rd
Murfreesboro, TN 37128-2945

Mailing address

2125 Rock Springs Midland Rd
Christiana, TN 37037-5357
Phone (615) 203-9098

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20180626000240 TN Practitioner - Optometry 7113986977 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Essential Eye Care, PLLCGroup PAC ID 9638572944, 2 clinicians

Practice addresses (Care Compare)

1524 Beasie Rd
Murfreesboro, TN 37128-2945
Phone (615) 439-2646

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2955MNMDRegistered Dietitian
1993TNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Music City Eye Care LLC Optometrist CurrentSince Feb 1, 2018 Accepting new patients
Essential Eye Care, PLLC Optometrist CurrentSince Jul 7, 2021 Accepting new patients
Music City Eye Care LLC Optometrist CurrentSince Feb 1, 2018 Accepting new patients
Visionworks Inc Past Accepting new patients
Music City Eye Care LLC Optometrist Past Accepting new patients

Locations

2012 Memorial Blvd
Murfreesboro, TN 37129
Phone (615) 203-5037

140 Joe B Jackson Pkwy
Murfreesboro, TN 37127
Phone (615) 203-9165

1524 Beasie Rd
Murfreesboro, TN 37128
Phone (615) 439-2641

Organizations & group practices 5

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": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1073597670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2125 ROCK SPRINGS MIDLAND RD",
            "city": "CHRISTIANA",
            "state": "TN",
            "postal_code": "370375357",
            "telephone_number": "615-203-9098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 BEASIE RD",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371282945",
            "telephone_number": "615-439-2646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANGELA",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "1993",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "2955",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

Verify at the official NPI Registry.