Active NPI
Katie Lea Johnson, O.D.
- Optometrist
- Little Rock, AR
National Provider Identifier
1073826608
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2651
- Practice address
- 424 N University Ave Ste 5And6
Little Rock, AR 72205-3109 - Phone
- (501) 663-1131
- NPI assigned
- Jul 25, 2010
- Last updated
- Mar 9, 2011
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2651 | AR | Primary |
Addresses
Primary practice location
424 N University Ave Ste 5And6
Little Rock, AR 72205-3109
Mailing address
9401 Johnson Rd
Mabelvale, AR 72103-2951
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 184071722 | Medicaid | AR |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2651 | AR | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| W. Brent Hall, O.D. P.a. | Optometrist | Past | Accepting new patients |
| Morgan Vision Clinic | Optometrist | Past | Accepting new patients |
| Bill F. Morgan, O.D. | Optometrist | Past | Accepting new patients |
| Arkansas Family Eyecare of Malvern | Optometrist | Past | Accepting new patients |
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299628800000",
"number": "1073826608",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9401 JOHNSON RD",
"city": "MABELVALE",
"state": "AR",
"postal_code": "721032951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "424 N UNIVERSITY AVE STE 5AND6",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722053109",
"telephone_number": "501-663-1131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "KATIE",
"middle_name": "LEA",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-07-25",
"last_updated": "2011-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "AR",
"license": "2651",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "184071722",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.