NPIMap

Organization Active NPI

Johnson Eyecare PC

Doing business as Johnson Eyecare and Eyewear

  • Optometrist
  • Minot, ND
National Provider Identifier
1073708533
Registry record updated Jun 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
648 Issued in ND
Legal business name
JOHNSON EYECARE PC
Doing business as
Johnson Eyecare and Eyewear
Practice address
1525 31St Ave SW
Suite E
Minot, ND 58701-2016
Phone
(701) 857-6050
Fax
(701) 857-6052
NPI assigned
Sep 7, 2007
Last updated
Jun 4, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2009

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

Authorized official

Name
Dr. Darin Lee Johnson, ODNPI 1710090485
Title
Owner
Phone
(701) 857-6050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 648 ND Primary

Addresses

Primary practice location

1525 31St Ave SW
Suite E
Minot, ND 58701-2016

Mailing address

1525 31St Ave SW
Suite E
Minot, ND 58701-2016
Phone (701) 857-6050

Other identifiers 1

IdentifierTypeStateIssuer
60643MedicaidND

Other names 1

  • Johnson Eyecare and Eyewear Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070928000595 ND Part B Supplier - Clinic/Group Practice 7517052079 Receives reassigned benefits from 3 practitioners
Practice locations: Minot, ND
O20100930072051 ND DME Supplier - Physician - OptometristDME Supplier - Optician 7517052079 Practice locations: Minot, ND

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Thomas Eyecare and Eyewear1525 31St Ave SW, Minot, ND 58701-2016(701) 857-6050 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses Accepts assignmentParticipating since Sep 13, 2007

National Provider Directory

National Provider Directory

Locations

1525 31st Ave SW
Ste E
Minot, ND 58701
Phone (701) 857-6050

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244073600000",
    "number": "1073708533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 31ST AVE SW",
            "address_2": "SUITE E",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587012016",
            "telephone_number": "701-857-6050",
            "fax_number": "701-857-6052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 31ST AVE SW",
            "address_2": "SUITE E",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587012016",
            "telephone_number": "701-857-6050",
            "fax_number": "701-857-6052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON EYECARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-07",
        "last_updated": "2009-06-04",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DARIN",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-857-6050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ND",
            "license": "648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60643",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Johnson Eyecare and Eyewear",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minot, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.