Jordan Johnson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

S-E18-TA-B35 Issued in AL

Practice address

2800 Ross Clark Cir
Dothan, AL 36301-2040

Phone

(334) 792-2211

NPI assigned

Aug 31, 2018

Last updated

Aug 31, 2018By 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 3

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Indiana University - School of Optometry, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Samuel J Teske OD PAGroup PAC ID 2860780574, 12 clinicians

Practice addresses (Care Compare)

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.

• Samuel J Teske OD PA

  dba The Eye Doctors of New Tampa

  • Optometrist
  • Tampa, FL
  • NPI 1073807962
  Medicare reassignment Care Compare group NPD
• Robson Eye Institute, PLLC

  dba Robson Eye Institute

  • Ophthalmology Physician
  • Clearwater, FL
  • NPI 1881230167
  NPD
• True Eye Experts West Palm LLC

  dba True Eye Experts Vero Beach

  • Optometrist
  • Vero Beach, FL
  • NPI 1184393720
  NPD

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

{
    "created_epoch": "1535673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535673600000",
    "number": "1194207662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363012040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 ROSS CLARK CIR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363012040",
            "telephone_number": "334-792-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JORDAN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-31",
        "last_updated": "2018-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003122",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC5588",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-E18-TA-B35",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carole Lea Johnson, M.D.
• Debra H Johnson, PT
• Elizabeth A Johnson, CRNA
• Haley A. Johnson
• Jessica Marcella Johnson, MS, LPC
• Judith L Johnson, CRNP
• June C Johnson
• Kassiah Johnson, RBT
• Lindsay Johnson
• Marjorie Louise Johnson, CRNP

• Optometrist in Dothan, AL
• Providers in Dothan, AL by specialty
• Optometrist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2018; 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.