Stephanie Johnson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1649DT Issued in KY

Practice address

200 Brule St
Fort Knox, KY 40121-6100

Phone

(502) 626-9993

Fax

(502) 624-0482

NPI assigned

Dec 15, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1295897015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 BRADEN WAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405098572",
            "telephone_number": "859-913-1091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BRULE ST",
            "city": "FORT KNOX",
            "state": "KY",
            "postal_code": "401216100",
            "telephone_number": "502-626-9993",
            "fax_number": "502-624-0482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1649DT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cree James
• Shelley James, CNM
• Joanne R Jansen, PHARMD, BCACP
• Dana Ona Jenkinson, APRN, NP-C
• Laura Eckler Johnson, PH.D.
• Shauna Jones, DDS, MS
• William Jones, PA
• Ayobami Kader, PHARMD
• Brenda Lee Kays, L.M.T.
• Diane Marie Kennedy, RPH

• Optometrist in Fort Knox, KY
• Providers in Fort Knox, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.