Individual provider Active NPI

Cameron Campbell Johnson, M.D.

  • Ophthalmology Physician
  • Canton, GA
National Provider Identifier
1417923657
Registry record updated Aug 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
067743 Issued in GA
Practice address
201 Kimberly Way Ste 106
Canton, GA 30114-8009
Phone
(678) 381-2020
Fax
(678) 381-2015
NPI assigned
Feb 27, 2006
Last updated
Aug 8, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X ME93228 FL
Ophthalmology Physician 207W00000X 067743 GA Primary

Addresses

Primary practice location

201 Kimberly Way Ste 106
Canton, GA 30114-8009

Mailing address

1300 Peachtree Industrial Blvd Ste 1201
Suwanee, GA 30024-4550
Phone (678) 381-2020

Other practice location 1

20 Glenlake Pkwy
Opthalmology
Atlanta, GA 30328
Phone (404) 365-0966

Other identifiers 1

IdentifierTypeStateIssuer
272941500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121008000334 GA Practitioner - Ophthalmology 9638109747 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Vanderbilt University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Milan Eye LLCGroup PAC ID 2668519109, 21 clinicians

Practice addresses (Care Compare)

11315 Johns Creek Pkwy
Suite 300
Johns Creek, GA 30097-1517
Phone (678) 381-2020

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.14 of 100Reported as group
Quality
94
Promoting interoperability
71
Improvement activities
40
Cost
77.3

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
067743GAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Southeast Permanente Medical Group CurrentSince Sep 4, 2012 Accepting new patients
Buford Eye Surgery Center CurrentSince Aug 1, 2015 Accepting new patients
Roswell Eye Surgery Center, LLC CurrentSince Dec 28, 2015 Accepting new patients
Milan Eye LLC Ophthalmology CurrentSince Aug 1, 2015 Accepting new patients
Canton Eye Surgery Center CurrentSince Aug 1, 2015 Accepting new patients
Woodhams Laser & Lens Implant Center LLC Past Accepting new patients
Alpharetta Eye Surgery Center LLC Past Accepting new patients
Ophthalmic Surgeons & Physicians LTD Ophthalmology PastSince Apr 5, 1996 Accepting new patients

Locations

2555 Westside Pkwy
Ste 300
Alpharetta, GA 30004

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

1995 Mall of Georgia Blvd
Ste C
Buford, GA 30519
Phone 67838120201022

201 Kimberly Way
Ste 104
Canton, GA 30114

201 Kimberly Way
Ste 106
Canton, GA 30114

201 Kimberly Way
Ste 200
Canton, GA 30114

970 Sanders Rd
Ste 100
Cumming, GA 30041

270 Walmart Way
Dahlonega, GA 30533
Phone (706) 867-6918

73 Prestige Ln
Ste 201
Dawsonville, GA 30534

1250 Scenic Hwy
Ste 1700
Lawrenceville, GA 30045
Phone (678) 853-7715

3775 Roswell Rd
Ste 175
Marietta, GA 30062

20 Glenlake Pkwy
Sandy Springs, GA 30328
Phone (770) 677-6247

1300 Peachtree Industrial Blvd
Ste 1201
Suwanee, GA 30024
Phone (770) 614-6266

1300 Peachtree Industrial
Dallas, TX 75373

Organizations & group practices 8

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1417923657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 PEACHTREE INDUSTRIAL BLVD STE 1201",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300244550",
            "telephone_number": "678-381-2020",
            "fax_number": "678-381-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 KIMBERLY WAY STE 106",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301148009",
            "telephone_number": "678-381-2020",
            "fax_number": "678-381-2015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Glenlake Pkwy",
            "address_2": "Opthalmology",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "30328",
            "country_code": "US",
            "telephone_number": "404-365-0966",
            "fax_number": "352-265-7081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CAMERON",
        "middle_name": "CAMPBELL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME93228",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "067743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272941500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

Verify at the official NPI Registry.