Intracoastal Eye, PLLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

200500742 Issued in NC

Legal business name

INTRACOASTAL EYE, PLLC

Practice address

8115 Market St Ste 312
Wilmington, NC 28411-8427

Phone

(910) 742-8384

NPI assigned

Apr 17, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Gregory James Johnson, MNPI 1063455020

Title

Member/Manager

Phone

(910) 777-8254

Specialties & licenses 1

Addresses

Other names 1

• Johnson Laser Eye Doing business as

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Practitioners 1

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

• Gregory James Johnson, M.D.

  • Ophthalmology Physician
  • Wilmington, NC
  • NPI 1063455020
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1429228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714348800000",
    "number": "1235526229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8115 MARKET ST STE 312",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284118427",
            "telephone_number": "910-742-8384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8115 MARKET ST STE 312",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284118427",
            "telephone_number": "910-742-8384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTRACOASTAL EYE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-17",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "MEMBER/MANAGER",
        "authorized_official_telephone_number": "910-777-8254",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "200500742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Johnson Laser Eye",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ophthalmology Physician in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Ophthalmology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; 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.