Gregory Charles Johnson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3116TX Issued in WA

Practice address

10202 149TH St E # 101
Puyallup, WA 98374-3746

Phone

(253) 841-2020

Fax

(253) 770-7378

NPI assigned

Jan 29, 2007

Sex

Male

Sole proprietor

Yes

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

Enrolled in WA

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

Pacific University - College of Optometry, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447396460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10202 149TH ST E # 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983743746",
            "telephone_number": "253-841-2020",
            "fax_number": "253-770-7378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10202 149TH ST E # 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983743746",
            "telephone_number": "253-841-2020",
            "fax_number": "253-770-7378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GREGORY",
        "middle_name": "CHARLES",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "3116TX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Johnson
• Audrey Johnson
• Cindy L Johnson, MSW
• Dana Ilene Johnson, LMP, MMP
• Gillian McRavin Johnson, MSN
• Holly N Johnson, M.D.
• James Johnson
• Jennifer Johnson
• Jessica Lindsey Johnson, DPT
• Kelsey Kay Johnson, RDN, LMCHA, CEDS, CD

• Optometrist in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Optometrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.