Individual provider Active NPI

Denise B Johnson, O.D.

  • Optometrist
  • Owasso, OK
National Provider Identifier
1609847102
Registry record updated Feb 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2057 Issued in OK
Practice address
8430 N 123Rd East Ave
Owasso, OK 74055-2130
Phone
(918) 272-5755
Fax
(918) 272-0330
NPI assigned
Feb 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2057 OK Primary

Addresses

Primary practice location

8430 N 123Rd East Ave
Owasso, OK 74055-2130

Mailing address

8430 N 123Rd East Ave
Owasso, OK 74055-2130
Phone (918) 272-5755

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AR2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20150902001185 TX Practitioner - Optometry 1658356969 Reassigns benefits to 1 organization
I20191223001721 AR Practitioner - Optometry 1658356969 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffries Eye Clinic PA Optometrist CurrentSince Jan 6, 2020 Accepting new patients
Martin, Wedel & Bullard, P.C. Optometrist CurrentSince Oct 12, 2015 Accepting new patients
Martin, Wedel & Bullard, P.C. Optometrist CurrentSince Oct 12, 2015 Accepting new patients
Martin, Wedel & Bullard, P.C. Optometrist Current Accepting new patients

Locations

3602 W Southern Hills Blvd
Rogers, AR 72758
Phone (479) 631-8900

839 N Nolan River Rd
Cleburne, TX 76033
Phone (817) 645-2411

4460 E Highway 287
Ste A
Midlothian, TX 76065
Phone (972) 775-8000

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393545600000",
    "number": "1609847102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8430 N 123RD EAST AVE",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740552130",
            "telephone_number": "918-272-5755",
            "fax_number": "918-272-0330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8430 N 123RD EAST AVE",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740552130",
            "telephone_number": "918-272-5755",
            "fax_number": "918-272-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DENISE",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-01",
        "last_updated": "2014-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owasso, OK

Sources for this page

Verify at the official NPI Registry.