Organization Active NPI

T.K. Johnson OD PC

  • Optician
  • Midland, MI
National Provider Identifier
1194042499
Registry record updated Oct 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
4901002282 Issued in MI
Legal business name
T.K. JOHNSON OD PC
Practice address
5908 Eastman Ave
Midland, MI 48640-6748
Phone
(989) 636-7200
Fax
(989) 636-7210
NPI assigned
Apr 26, 2010
Last updated
Oct 14, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2026

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

Authorized official

Name
Mrs. Judy B Miller
Title
Office Manager
Phone
(989) 636-7200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 156FX1800X 4901002282 MI Primary
Durable Medical Equipment & Medical Supplies 332B00000X 4901002282 MI

Addresses

Primary practice location

5908 Eastman Ave
Midland, MI 48640-6748

Mailing address

5908 Eastman Ave
Midland, MI 48640-6748
Phone (989) 636-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120413000423 MI Part B Supplier - Clinic/Group Practice 0042339152 Receives reassigned benefits from 1 practitioner
Practice locations: Midland, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791936000000",
    "number": "1194042499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5908 EASTMAN AVE",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406748",
            "telephone_number": "989-636-7200",
            "fax_number": "989-636-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5908 EASTMAN AVE",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486406748",
            "telephone_number": "989-636-7200",
            "fax_number": "989-636-7210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "T.K. JOHNSON OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-26",
        "last_updated": "2026-10-14",
        "certification_date": "2026-10-14",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "989-636-7200",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "MI",
            "license": "4901002282",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MI",
            "license": "4901002282",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.