Spencer Johnson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

5937796-9934 Issued in UT

Practice address

12357 S 450 E Ste 2
Draper, UT 84020-8127

Phone

(801) 572-9804

Fax

(801) 572-9805

NPI assigned

Oct 2, 2006

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 UT, TX, OK3 enrollments

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 3

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. 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.

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 and National Provider Directory roles.

• Complete Eye Care

  • Optometrist
  • Orem, UT
  • NPI 1871950444
  Medicare reassignment NPD
• Rocky Mountain University of Health Professions Foundation

  • Physical Therapist
  • Provo, UT
  • NPI 1053174417

  Optometrist

  Medicare reassignment NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Sallisaw, OK
  • NPI 1780692723

  TX

  Medicare reassignment NPD
• Northeastern State University College of Optometry

  • Optometrist
  • Tahlequah, OK
  • NPI 1437106333
  Medicare reassignment NPD
• Spencer D Johnson OD PC

  • Optometrist
  • Draper, UT
  • NPI 1336315613
  NPD (past) Authorized official
• Cherokee Nation

  • Public Health or Welfare Agency
  • Tahlequah, OK
  • NPI 1013884154
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Muskogee, OK
  • NPI 1841207156
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Ochelata, OK
  • NPI 1871972430
  NPD
• Robin Segal, OD LLC

  • Optometrist
  • Glastonbury, CT
  • NPI 1770813339
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487747408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12357 S 450 E STE 2",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840208127",
            "telephone_number": "801-572-9804",
            "fax_number": "801-572-9805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12357 S 450 E STE 2",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840208127",
            "telephone_number": "801-572-9804",
            "fax_number": "801-572-9805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SPENCER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "5937796-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jada Johnson
• Jade Johnson
• Jennifer Holt Johnson, PA-C
• Melissa Lowder Johnson, APRN DNP PMHNP
• Sabrina Johnson
• Jonathan Davis Counseling Services, LLC
• Jonathan J. Ririe, Inc.
• Aspen Wayment Jones, PHYSICIAN ASSISTANT
• Coralyn Jones
• Elizabeth Jones

• Optometrist in Draper, UT
• Providers in Draper, UT by specialty
• Optometrist in Utah

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.