Ryan Daniel Johnson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

MN-3176 Issued in MN

Practice address

8362 Tamarack Village
RM 108
Woodbury, MN 55125-3392

Phone

(651) 730-9662

NPI assigned

Sep 3, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Luxottica of America Inc.

  dba Lenscrafters #894

  • Eyewear Supplier
  • Woodbury, MN
  • NPI 1578618617
  NPD (past)
• Luxottica of America Inc

  dba Lenscrafters #E895

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)

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

{
    "created_epoch": "1251936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251936000000",
    "number": "1093948259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8362 TAMARACK VILLAGE",
            "address_2": "RM 108",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551253392",
            "telephone_number": "651-730-9662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8362 TAMARACK VILLAGE",
            "address_2": "RM 108",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551253392",
            "telephone_number": "651-730-9662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RYAN",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-03",
        "last_updated": "2009-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MN",
            "license": "MN-3176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Randall Johnson, MD
• Miriah J Johnson, DPT
• Rachel Valerie Johnson, PA-C
• Reed A Johnson, MD
• Rose Johnson, LPCC
• Theresa Marie Johnson
• Tina Marie Johnson, M.D.
• Travis Allan Johnson, D.D.S.
• Tyree Deshawn Johnson
• Victoria L Johnson, LPCC

• Optometrist in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Optometrist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.