Individual provider Active NPI

Kathryn Falk Johnson, O.D.

  • Optometrist
  • Dublin, GA
National Provider Identifier
1659670982
Registry record updated Jun 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT002643 Issued in GA
Practice address
2400 Bellevue Rd
18 Erin Office Park
Dublin, GA 31021-2885
Phone
(478) 272-5933
Fax
(478) 272-4350
NPI assigned
Mar 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4533 FL
Optometrist 152W00000X OPT002643 GA Primary

Addresses

Primary practice location

2400 Bellevue Rd
18 Erin Office Park
Dublin, GA 31021-2885

Mailing address

2400 Bellevue Rd
18 Erin Office Park
Dublin, GA 31021-2885
Phone (478) 272-5933

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20111007000422 GA Practitioner - Optometry 2567634900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dublin Eye Associates, P.C.Group PAC ID 9032112024, 6 clinicians

Practice addresses (Care Compare)

18 Erin Office Park
Dublin, GA 31021-2866
Phone 4782725933136

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4533FLMDOptometrist
OPT002643GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dublin Eye Associates, P.C. CurrentSince Aug 30, 2011 Accepting new patients

Locations

2400 Bellevue Rd
Ste 18
Dublin, GA 31021
Phone (478) 272-5933

700 Maple Dr
Vidalia, GA 30474
Phone (912) 537-1991

Interoperability endpoints

  • Direct secure messaging: kjohnson@dublineye.direct.eyemdemr.com

Organizations & group practices 1

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": "1301011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435536000000",
    "number": "1659670982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 BELLEVUE RD",
            "address_2": "18 ERIN OFFICE PARK",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212885",
            "telephone_number": "478-272-5933",
            "fax_number": "478-272-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 BELLEVUE RD",
            "address_2": "18 ERIN OFFICE PARK",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212885",
            "telephone_number": "478-272-5933",
            "fax_number": "478-272-4350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KATHRYN",
        "middle_name": "FALK",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-25",
        "last_updated": "2015-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "4533",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, GA

Sources for this page

Verify at the official NPI Registry.