Shane Johnson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2262 Issued in CO

Practice address

5403 W 88TH Ave
SP #45
Westminster, CO 80031-3084

Phone

(303) 428-1220

Fax

(303) 657-8689

NPI assigned

Jan 3, 2007

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 CO

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: 33378@visionworks.emadirect.md

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.

• Sowash Optometry Group PC

  dba VisionWorks

  • Optometrist
  • Lakewood, CO
  • NPI 1336172055
  Medicare reassignment NPD
• Sowash Optometry Group, PC

  dba Visionworks

  • Eyewear Supplier
  • Denver, CO
  • NPI 1891404174

  Optometrist

  NPD

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508923731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11103 WEST AVE",
            "address_2": "STE 6",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782131370",
            "telephone_number": "210-524-6803",
            "fax_number": "210-524-6587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5403 W 88TH AVE",
            "address_2": "SP #45",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800313084",
            "telephone_number": "303-428-1220",
            "fax_number": "303-657-8689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHANE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Conrad C Johnson, D.M.D. M.S.D.
• Drake Johnson
• Jeremiah Roger Johnson, PT, DPT, ATC
• Matha K Johnson
• Nathan M Johnson, DDS
• Shelly Johnson
• Trevor Gregg Johnson, DMD
• Marissa Johnston, RBT
• Ankur Jolly, D.D.S.
• Abra Jones, BA

• Optometrist in Westminster, CO
• Providers in Westminster, CO by specialty
• Optometrist in Colorado

• 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.