Mandy Jane Johnson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1220 Issued in NE

Practice address

5403 N Ave
Kearney, NE 68847-8514

Phone

(308) 234-9133

Fax

(308) 234-4006

NPI assigned

Apr 22, 2006

Sex

Female

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 NE

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

Specialty

Optometry

Education

Indiana University - School of Optometry, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mandy O.D., P.C.Group PAC ID 2163501974, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mandy O.D., P.C.

  • Optometrist
  • Kearney, NE
  • NPI 1710166996
  Medicare reassignment Care Compare group NPD Authorized official
• Dennis P. Sherrerd, OD,PC

  • Optometrist
  • Kearney, NE
  • NPI 1346279072
  NPD (past)

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

{
    "created_epoch": "1145664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1679539274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5403 N AVE",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688478514",
            "telephone_number": "308-234-9133",
            "fax_number": "308-234-4006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5403 N AVE",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688478514",
            "telephone_number": "308-234-9133",
            "fax_number": "308-234-4006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MANDY",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-22",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NE",
            "license": "1220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blake Johnson, PA-C
• Kaleigh Anne Johnson, RN
• Kit Johnson, LADC, CDGC, LIMHP
• Kyler Michelle Johnson, PHYSICIAN ASSISTANT
• Lynette Johnson
• Michael Saul Johnson
• Rochelle R Johnson, RN
• Rodney L. Johnson, MD
• Ronda Johnson
• Sadie Johnson, PA-C

• Optometrist in Kearney, NE
• Providers in Kearney, NE by specialty
• Optometrist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.