Cynthia Ruth Johnson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

530 Issued in MT

Practice address

4265 Fallon St,
Suite 1
Bozeman, MT 59718

Phone

(406) 587-0668

Fax

(406) 587-0396

NPI assigned

Sep 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cynthia Ruth Kinna Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225152000000",
    "number": "1255423307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4265 FALLON ST",
            "address_2": "SUITE 1",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597186756",
            "telephone_number": "406-587-0668",
            "fax_number": "406-587-0396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4265 FALLON ST,",
            "address_2": "SUITE 1",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "59718",
            "telephone_number": "406-587-0668",
            "fax_number": "406-587-0396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CYNTHIA",
        "middle_name": "RUTH",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2008-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MT",
            "license": "530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0480318",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CYNTHIA",
            "last_name": "KINNA",
            "middle_name": "RUTH",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tyler Joanou, LMT
• John a. Vallin, M.D., LLC
• John K H Griffith (Medical Arts Pharmacy)
• Ashley Johnson, LCSW
• Christene M Johnson, PAC
• David Bruce Johnson
• Eric L Johnson, M.D.
• Jay Johnson
• Jeff T Johnson, LPC, LCPC
• Jennifer Anne Johnson, NP

• Optometrist in Bozeman, MT
• Providers in Bozeman, MT by specialty
• Optometrist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; 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.