Individual provider Active NPI

Sharon Laruth Johnson, O.D.

  • Optometrist
  • Fort Hood, TX
National Provider Identifier
1528113669
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4666TG Issued in TX
Practice address
BLDG. 33003, Batallion Ave.
Monroe Troop Medical Clinic
Fort Hood, TX 76544-4752
Phone
(254) 288-5087
Fax
(254) 287-3534
NPI assigned
Jan 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4666TG TX Primary

Addresses

Primary practice location

BLDG. 33003, Batallion Ave.
Monroe Troop Medical Clinic
Fort Hood, TX 76544-4752

Mailing address

4205 Timber Trail CT
Arlington, TX 76016-4623
Phone (817) 996-2881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4666TGTXMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528113669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 TIMBER TRAIL CT",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760164623",
            "telephone_number": "817-996-2881",
            "fax_number": "817-561-6474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDG. 33003, BATALLION AVE.",
            "address_2": "MONROE TROOP MEDICAL CLINIC",
            "city": "FORT HOOD",
            "state": "TX",
            "postal_code": "765444752",
            "telephone_number": "254-288-5087",
            "fax_number": "254-287-3534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHARON",
        "middle_name": "LARUTH",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "4666TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Hood, TX

Sources for this page

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

Verify at the official NPI Registry.