Individual provider Active NPI

Parker Johnson, OD

  • Optometrist
  • Ann Arbor, MI
National Provider Identifier
1114544947
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4901005456 Issued in MI
Practice address
955 W Eisenhower Cir Ste F
Ann Arbor, MI 48103-5868
Phone
(734) 332-8840
Fax
(734) 332-8841
NPI assigned
Jun 27, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4901005456 MI Primary

Addresses

Primary practice location

955 W Eisenhower Cir Ste F
Ann Arbor, MI 48103-5868

Mailing address

955 W Eisenhower Cir Ste F
Ann Arbor, MI 48103-5868
Phone (734) 332-8840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20200721002711 MI Practitioner - Optometry 8123442324 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ferris State College - College of Optometry, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

955 W Eisenhower Cir
Suite F
Ann Arbor, MI 48103-5868
Phone (734) 332-8840

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4901005456MIMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ann Arbor Vision Care, PC Optometrist CurrentSince Jul 1, 2024 Accepting new patients

Locations

955 W Eisenhower Cir
Ste F
Ann Arbor, MI 48103
Phone (734) 332-8840

Organizations & group practices 2

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": "1593216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1114544947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 W EISENHOWER CIR STE F",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481035868",
            "telephone_number": "734-332-8840",
            "fax_number": "734-332-8841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 W EISENHOWER CIR STE F",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481035868",
            "telephone_number": "734-332-8840",
            "fax_number": "734-332-8841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PARKER",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-27",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901005456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.