Gary E. Johnson, O.D., P.C.

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

607 Issued in ND

Legal business name

GARY E. JOHNSON, O.D., P.C.

Practice address

3757 55TH Ave S
Fargo, ND 58104-6365

Phone

(701) 356-1717

Fax

(701) 356-1718

NPI assigned

Nov 8, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Gary Elijah Johnson, O.D.

Title

President

Phone

(701) 640-8773

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Dale K Hoffmann, O.D.

  • Optometrist
  • Detroit Lakes, MN
  • NPI 1396745550
  NPD (past)

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

{
    "created_epoch": "1289174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294704000000",
    "number": "1235430216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3757 55TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581046365",
            "telephone_number": "701-356-1717",
            "fax_number": "701-356-1718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3757 55TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581046365",
            "telephone_number": "701-356-1717",
            "fax_number": "701-356-1718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY E. JOHNSON, O.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-08",
        "last_updated": "2011-01-11",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "ELIJAH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-640-8773",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "ND",
            "license": "607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen P Garrity, MD
• Kou Gartei
• Catherine M Garvey, PA-C
• Gary a. Matthys MD PLC
• Gary Cornforth
• Gary L. Renier, O.D. LTD
• Enej Gasevic, M.D.
• Krin Lee Gast, ASCP
• Amie Gatawah
• Nicholas Gau, M.D.

• Exclusive Provider Organization in Fargo, ND
• Providers in Fargo, ND by specialty
• Exclusive Provider Organization in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.