Individual provider Active NPI

David Christopher Johnson, OD

  • Optometrist
  • Dallas, OR
National Provider Identifier
1396611208
Registry record updated Oct 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4803 Issued in OR
Practice address
986 SE Uglow Ave
Dallas, OR 97338-2643
Phone
(503) 623-3538
NPI assigned
Oct 16, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4803 OR Primary

Addresses

Primary practice location

986 SE Uglow Ave
Dallas, OR 97338-2643

Mailing address

986 SE Uglow Ave
Dallas, OR 97338-2643

Other practice location 1

617 Clay St E
Monmouth, OR 97361-2402
Phone (503) 837-0281

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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

Enrollment IDStateProvider typePAC IDDetails
I20260407001435 OR Practitioner - Optometry 4385119429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

617 Clay St E
Monmouth, OR 97361-2402

986 SE Uglow Ave
Dallas, OR 97338-2643

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4803ORMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Christopher D. Johnson OD, PC Optometrist CurrentSince Oct 21, 2025 Accepting new patients
Christopher D. Johnson OD, PC Optometrist PastSince Oct 21, 2025 Accepting new patients

Locations

986 SE Uglow Ave
Dallas, OR 97338
Phone (503) 623-3538

617 Clay St E
Monmouth, OR 97361
Phone (503) 623-3538

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1760572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760572800000",
    "number": "1396611208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "986 SE UGLOW AVE",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973382643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "986 SE UGLOW AVE",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "973382643",
            "telephone_number": "503-623-3538"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "617 Clay St E",
            "address_purpose": "LOCATION",
            "city": "Monmouth",
            "state": "OR",
            "postal_code": "973612402",
            "country_code": "US",
            "telephone_number": "503-837-0281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DAVID",
        "middle_name": "CHRISTOPHER",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-10-16",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "4803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, OR

Sources for this page

Verify at the official NPI Registry.