Ryan Scott Johnson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP-1037 Issued in ID

Practice address

4240 Yellowstone Ave
Chubbuck, ID 83202-2420

Phone

(208) 238-2020

Fax

(208) 238-2069

NPI assigned

Jun 30, 2006

Last updated

Jul 19, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

Optometry

Education

Pacific Medical College, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alameda Vision IncGroup PAC ID 6608995303, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Alameda Vision Inc.

  • Optometrist
  • Pocatello, ID
  • NPI 1114901535
  Medicare reassignment Care Compare group NPD
• Rsjohnson OD PLLC

  • Optometrist
  • Chubbuck, ID
  • NPI 1760052401
  NPD Authorized official

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1184653404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12482 DALLIN RD",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832025073",
            "telephone_number": "208-241-9145",
            "fax_number": "208-238-2069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4240 YELLOWSTONE AVE",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832022420",
            "telephone_number": "208-238-2020",
            "fax_number": "208-238-2069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RYAN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-1037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807153600",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Austin Job, PARAPROFESSIONAL
• Allison Clark Joe
• John Hochhalter, LPC
• Emily Michelle Johnson, PHARMD
• Jamey Johnson, PT, DPT
• Shawna Johnson, BI
• Beverly Grigg Jones, LPC, NCC
• Robert Randall Jones Jr., MD
• William Jordan, PHARMD
• Grace Elaine Jory, PT, DPT

• Optometrist in Chubbuck, ID
• Providers in Chubbuck, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.