Jennifer L Johnson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

5869TG Issued in TX

Practice address

124 E Bandera Rd
Ste 403
Boerne, TX 78006-2849

Phone

(830) 331-8745

Fax

(866) 897-9855

NPI assigned

Jan 11, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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, 2000

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifer.johnson@direct.revolutionehr.com

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.

• Johnson Eye Care PLLC

  • Optometrist
  • Boerne, TX
  • NPI 1841718897
  Medicare reassignment NPD Authorized official
• Timithy M Dunham MD PA

  • Ophthalmology Physician
  • San Antonio, TX
  • NPI 1861602583

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315958400000",
    "number": "1457401747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 E BANDERA RD",
            "address_2": "STE 403",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780062849",
            "telephone_number": "830-331-8745",
            "fax_number": "866-897-9855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 E BANDERA RD",
            "address_2": "STE 403",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780062849",
            "telephone_number": "830-331-8745",
            "fax_number": "866-897-9855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2011-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5869TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168232001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Jimenez
• Stephanie Jimenez, LVN
• Joel B Nilsson MD PA
• Johnson Eye Care PLLC
• Jennifer E Johnson, MS, CCC-SLP
• Kenneth Jay Johnson
• Madeline Alexis Johnson
• Susan Ly Johnson, O.D.
• Emma Ryckman Jonas
• Ashlie Solansky Jones, RN

• Optometrist in Boerne, TX
• Providers in Boerne, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2011; 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.