Ryan Johnson, O.D

Primary specialty

Vision Therapy OptometristTaxonomy code 152WV0400X

License

ODP-100269 Issued in ID

Practice address

7960 W Rifleman St
Suite 150
Boise, ID 83704-9064

Phone

(208) 377-8899

NPI assigned

Jul 2, 2012

Last updated

Jul 23, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jeffrey C JohnsonGroup PAC ID 5092763565, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Jeffrey C. Johnson

  • Optometrist
  • Boise, ID
  • NPI 1568632941
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437609600000",
    "number": "1366706525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7960 W RIFLEMAN ST",
            "address_2": "SUITE 150",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049064",
            "telephone_number": "208-377-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7960 W RIFLEMAN ST",
            "address_2": "SUITE 150",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049064",
            "telephone_number": "208-377-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RYAN",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-02",
        "last_updated": "2015-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "14467",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "ID",
            "license": "ODP-100269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Marie Johnson, LPC
• Patti Jean Johnson, LPC,NCC
• Rachel Johnson
• Rhonda L Johnson
• Robby Gordon Johnson, MA
• Ryan Johnson
• Ryan Tyler Johnson, DPM
• Sarah Ann Johnson, LMSW
• Shae Hal Johnson, DO
• Skye J Johnson, LMSW

• Vision Therapy Optometrist in Boise, ID
• Providers in Boise, ID by specialty
• Vision Therapy Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; 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.