Terry Johnson

Primary specialty

OpticianTaxonomy code 156FX1800X

License

4901002282 Issued in MI

Legal business name

TERRY JOHNSON

Practice address

5908 Eastman Ave
Midland, MI 48640-6748

Phone

(989) 636-7200

Fax

(989) 636-7210

NPI assigned

Apr 26, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Denise E. Burch

Title

Office Manager

Phone

(989) 636-7200

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• T K Johnson, O.D.

  • Optometrist
  • Midland, MI
  • NPI 1073612107
  Medicare reassignment NPD

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649203200000",
    "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": "TERRY JOHNSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-26",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A",
        "authorized_official_last_name": "BURCH",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "E.",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1547439",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Michele Tessin
• Kayla Gabrielle Thatcher
• The Apothecary Shoppe Pharmacies, LLC

• Optician in Midland, MI
• Providers in Midland, MI by specialty
• Optician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.