Individual provider Active NPI

Jarrett Ann Johnson, OD,MPH

  • Optometrist
  • New Orleans, LA
National Provider Identifier
1174540629
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1128-113T Issued in LA
Practice address
1530 N Broad St
New Orleans, LA 70119-2334
Phone
(504) 943-0070
Fax
(504) 943-0072
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1128-113T LA Primary

Addresses

Primary practice location

1530 N Broad St
New Orleans, LA 70119-2334

Mailing address

1530 N Broad St
New Orleans, LA 70119-2334
Phone (504) 943-0070

Other identifiers 1

IdentifierTypeStateIssuer
1978957MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20060426000016 LA Practitioner - Optometry 2062422769 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1530 N Broad St
New Orleans, LA 70119-2334
Phone (504) 943-0070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jarrett Ann Johnson a Professional Optometry Corporation Optometrist CurrentSince Jul 1, 1993 Accepting new patients

Locations

4200 Washington Ave
Ste A
New Orleans, LA 70125
Phone (504) 609-3777

1530 N Broad St
New Orleans, LA 70119
Phone (504) 943-0070

Organizations & group practices 1

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174540629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 N BROAD ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701192334",
            "telephone_number": "504-943-0070",
            "fax_number": "504-943-0072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 N BROAD ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701192334",
            "telephone_number": "504-943-0070",
            "fax_number": "504-943-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JARRETT",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "OD,MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1128-113T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1978957",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.