Active NPI
Alex Walker Johnson, DO
- Ophthalmology Physician
- Port Royal, SC
National Provider Identifier
1245806736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 93824
- Practice address
- 1664 Ribaut Rd
Port Royal, SC 29935-1708 - Phone
- (843) 522-8466
- NPI assigned
- Jun 3, 2021
- Last updated
- Sep 14, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 12871 | GA | |
| Ophthalmology Physician | 207W00000X | 12871 | GA | |
| Ophthalmology Physician | 207W00000X | 93824 | SC | Primary |
| Ophthalmology Physician | 207W00000X | 0102210338 | VA |
Addresses
Primary practice location
1664 Ribaut Rd
Port Royal, SC 29935-1708
Mailing address
125 Furrow LN
Ladys Island, SC 29907-1272
Phone (606) 316-2562
Other practice location 1
116 Nationwide Dr
Lynchburg, VA 24502-4271
Phone (434) 947-3984
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12871 | Other | GA | GEORGIA RESIDENCY TRAINING PERMIT |
| 938240 | Medicaid | SC | |
| 93824 | Other | SC | SC MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Ophthalmology
- Education
- Liberty Univ College of Osteopathic Medicine, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1664 Ribaut Rd
Port Royal, SC 29935-1708
Phone (843) 522-8466
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 100 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12871 | GA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beaufort Eye Center P a | Multi-Specialty | Current | Accepting new patients |
| Beaufort Eye Optical | Multi-Specialty | Current | Accepting new patients |
Locations
103 Okatie Center Blvd N
Ste 103
Okatie, SC 29909
Phone (843) 522-8466
1664 Ribaut Rd
Port Royal, SC 29935
Phone (843) 522-8466
Interoperability endpoints
- ajohnson@bec.intellechartdirect.net
Organizations & group practices 2
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.
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Beaufort, SC
- NPI 1366436073
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789344000000",
"number": "1245806736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 FURROW LN",
"city": "LADYS ISLAND",
"state": "SC",
"postal_code": "299071272",
"telephone_number": "606-316-2562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1664 RIBAUT RD",
"city": "PORT ROYAL",
"state": "SC",
"postal_code": "299351708",
"telephone_number": "843-522-8466"
}
],
"practiceLocations": [
{
"address_1": "116 Nationwide Dr",
"address_purpose": "LOCATION",
"city": "Lynchburg",
"state": "VA",
"postal_code": "245024271",
"country_code": "US",
"telephone_number": "434-947-3984",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "ALEX",
"middle_name": "WALKER",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-06-03",
"last_updated": "2026-09-14",
"certification_date": "2026-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "GA",
"license": "12871",
"primary": false
},
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "GA",
"license": "12871",
"primary": false
},
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "SC",
"license": "93824",
"primary": true
},
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "VA",
"license": "0102210338",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GEORGIA RESIDENCY TRAINING PERMIT",
"identifier": "12871",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "938240",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SC MEDICAL LICENSE",
"identifier": "93824",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Royal, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 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; 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.