Jarvis Johnson

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPTO002920 Issued in GA

Practice address

673 W Washington St
Monticello, GA 31064-1371

Phone

(706) 468-8598

NPI assigned

Sep 1, 2015

Last updated

May 1, 2025By 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 1

Addresses

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: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern College of Optometry, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

360Care Services of Georgia LLCGroup PAC ID 5991145112, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• 360Care Services of Georgia LLC

  • Optometrist
  • Norcross, GA
  • NPI 1871353599
  Medicare reassignment Care Compare group NPD
• Crescent Eye Care LLC

  • Optometrist
  • Monticello, GA
  • NPI 1053100578
  Medicare reassignment NPD Authorized official
• Ga Doctors of Optometry LLC

  • Optometrist
  • Lithonia, GA
  • NPI 1174105936
  Medicare reassignment NPD
• Second Sight LLC

  • Optometrist
  • Griffin, GA
  • NPI 1467032771
  Medicare reassignment NPD
• Ga Doctors of Optometry LLC

  • Eyewear Supplier
  • Columbus, GA
  • NPI 1013599745

  Optometrist

  NPD
• Dr. Terry H. Wynne, Optometrist, P.C.

  • Eyewear Supplier
  • Griffin, GA
  • NPI 1871762823
  NPD (past)
• Robert L Elwelljr OD PC

  • Optometrist
  • Tucker, GA
  • NPI 1891766952
  NPD (past)

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

{
    "created_epoch": "1441065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1447627815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 CRESCENT DR",
            "city": "FORSYTH",
            "state": "GA",
            "postal_code": "310295464",
            "telephone_number": "478-233-0869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "673 W WASHINGTON ST",
            "city": "MONTICELLO",
            "state": "GA",
            "postal_code": "310641371",
            "telephone_number": "706-468-8598"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2032 Veterans Blvd",
            "address_purpose": "LOCATION",
            "city": "Dublin",
            "state": "GA",
            "postal_code": "310213042",
            "country_code": "US",
            "telephone_number": "478-272-3445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JARVIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-01",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPTO002920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasper Health Services Inc. (Primary Care Center North)
• Jasper Health Services Inc. (The Retreat)
• Jasper Health Services, Inc. (Jasper Memorial Hospital)
• Jasper Health Services, Inc. (Jasper Memorial Hospital)
• Ruby Catherine Jenkins, M.A.
• Lyndsy Holman Johnston, D.C.
• Nataliya Kubasova, MD
• David Keith Leach, PHARM. D.
• Tyler Keith Lipham, DMD
• Lovely Living Personal Care Home

• Optometrist in Monticello, GA
• Providers in Monticello, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.
• 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.