Matthew Brant Johnson, LDO

Primary specialty

OpticianTaxonomy code 156FX1800X

License

6429 Issued in MA

Practice address

1 Porter SQ
Cambridge, MA 02140-1431

Phone

(617) 864-7005

Fax

(617) 864-3250

NPI assigned

Feb 24, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1424736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424736000000",
    "number": "1144612334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PORTER SQ",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021401431",
            "telephone_number": "617-864-7005",
            "fax_number": "617-864-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PORTER SQ",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021401431",
            "telephone_number": "617-864-7005",
            "fax_number": "617-864-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MATTHEW",
        "middle_name": "BRANT",
        "name_prefix": "Mr.",
        "credential": "LDO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-24",
        "last_updated": "2015-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FC0801X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Contact Lens Fitter",
            "state": "MA",
            "license": "6429",
            "primary": false
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "MA",
            "license": "6429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Henry Joel Johnson, RN
• Jennifer Johnson, CNM
• Jessica Lynn Johnson, MA
• Kimberly NE'Sha Johnson, LPN
• Mark William Johnson, MD
• Michelle Rullan Johnson, MD
• Nancy Taylor Johnson, LMHC
• Nia Noelle Johnson, MSC
• Sarah Johnson, M.D.
• Sarah Emily Johnson, LIC. AC., DIPL. O.M.

• Optician in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Optician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.