Dr Matthew Johannes OD, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1552 Issued in KS

Legal business name

DR MATTHEW JOHANNES OD, LLC

Practice address

410 N Campus Dr
Garden City, KS 67846-6134

Phone

(620) 275-2222

Fax

(620) 275-0829

NPI assigned

Jul 30, 2014

Organization subpart

No

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

Authorized official

Name

Matthew Johannes, ODNPI 1346331089

Title

Optometrist

Phone

(620) 275-2222

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KS2 enrollments

Enrollment records 2

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew E Johannes, OD

  • Optometrist
  • Garden City, KS
  • NPI 1346331089
  Medicare reassignment Authorized official
• Kristina R Reimer, O.D.

  • Optometrist
  • Garden City, KS
  • NPI 1184715823
  NPD

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

{
    "created_epoch": "1406678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586822400000",
    "number": "1508274960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 N CAMPUS DR",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "678466134",
            "telephone_number": "620-275-2222",
            "fax_number": "620-275-0829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 N CAMPUS DR",
            "city": "GARDEN CITY",
            "state": "KS",
            "postal_code": "678466134",
            "telephone_number": "620-275-2222",
            "fax_number": "620-275-0829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR MATTHEW JOHANNES OD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-30",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A",
        "authorized_official_last_name": "JOHANNES",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "620-275-2222",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200259360A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul Alan Kinso Doi, DDS, MS
• Emma Kate Doll
• Merilyn K Douglass, ARNP
• Vicki Downey, LPC
• Elizabeth A. Doyle, M.D.
• Adam Joseph Drees, O.D.
• Brenda Drees, PT
• Kayla Dreiling
• DRS Hopkins Ackerman & Drees LLC
• Idalia Duncan, LSCSW

• Optometrist in Garden City, KS
• Providers in Garden City, KS by specialty
• Optometrist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.