Gordon Stanley Johnson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

815 Issued in SC

Practice address

2827 Woodruff Rd
Simpsonville, SC 29681-4807

Phone

(864) 520-2480

NPI assigned

Aug 22, 2006

Sex

Male

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

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Ohio State University - College of Optometry, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clark Optometric Center of SC P.a.Group PAC ID 0446596274, 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: direct@blueridgevisionassociatesgreersc.compulinkdirect.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Clark Optometric Center of SC, P.a.

  • Optometrist
  • Simpsonville, SC
  • NPI 1063981900
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566777600000",
    "number": "1295841369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2827 WOODRUFF RD",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296814807",
            "telephone_number": "864-877-3031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2827 WOODRUFF RD",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296814807",
            "telephone_number": "864-520-2480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GORDON",
        "middle_name": "STANLEY",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2019-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DOO815",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nikita L Joe, RN
• Ann Greene Johns, MD
• Daniel Johnson
• Donna K Johnson, RN, MSN, APRN, NP-C
• Felicia Rena Johnson
• Gretchen Heidt Johnson, M.D.
• Laura Anne Johnson, M.D.
• Valerie Giselle Johnson, MSOT
• Willie Mae Johnson
• Thomas W Johnston, DC

• All providers in Simpsonville, SC
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; 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.