Phillip E Johnson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT000841 Issued in GA

Practice address

3455 Peachtree Industrial Blvd
Suite 845
Duluth, GA 30096-6501

Phone

(770) 476-3606

Fax

(770) 476-2818

NPI assigned

Nov 6, 2006

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 GA

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

Southern College of Optometry, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Gwinnett Eye Clinic

  • Optometrist
  • Duluth, GA
  • NPI 1619093531
  Medicare reassignment NPD

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184703464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3455 PEACHTREE INDUSTRIAL BLVD",
            "address_2": "SUITE 845",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300966501",
            "telephone_number": "770-476-3606",
            "fax_number": "770-476-2818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 PEACHTREE INDUSTRIAL BLVD",
            "address_2": "SUITE 845",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300966501",
            "telephone_number": "770-476-3606",
            "fax_number": "770-476-2818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PHILLIP",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT000841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nadia Johnson-Trujillo
• Bree Johnson
• Gwenyth L Johnson, RD, LD
• Jade Johnson
• Jennifer Johnson
• Pierce Johnson, LMT
• Sherry Easton Johnson, OTR/L
• Susan J Johnson, PA-C
• Vernard Johnson
• Darlene Jones, CNA

• Optometrist in Duluth, GA
• Providers in Duluth, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.