NPIMap

Organization Active NPI

Jarrett Ann Johnson a Professional Optometry Corporation

Doing business as Primary Eye Care

  • Optometrist
  • New Orleans, LA
National Provider Identifier
1700058567
Registry record updated Aug 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1128-113T Issued in LA
Legal business name
JARRETT ANN JOHNSON A PROFESSIONAL OPTOMETRY CORPORATION
Doing business as
Primary Eye Care
Practice address
1530 N Broad St
New Orleans, LA 70119-2334
Phone
(504) 943-0070
Fax
(504) 943-0072
NPI assigned
Apr 1, 2008
Last updated
Aug 18, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2015

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

Authorized official

Name
Dr. Jarrett Ann Johnson, OD,MPHNPI 1174540629
Title
Owner
Phone
(504) 943-0070

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 1128-113T LA Primary
Corneal and Contact Management OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152WC0802X 1128-133T LA

Addresses

Primary practice location

1530 N Broad St
New Orleans, LA 70119-2334

Mailing address

1530 N Broad St
New Orleans, LA 70119-2334
Phone (504) 943-0070

Other identifiers 1

IdentifierTypeStateIssuer
1449652MedicaidLA

Other names 1

  • Primary Eye Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110315000793 LA Part B Supplier - Clinic/Group Practice 6709068554 Receives reassigned benefits from 4 practitioners
Practice locations: New Orleans, LA

National Provider Directory

National Provider Directory

Locations

1530 N Broad St
New Orleans, LA 70119
Phone (504) 943-0070

4200 Washington Ave
Ste A
New Orleans, LA 70125
Phone (504) 609-3777

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1207008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439856000000",
    "number": "1700058567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 N BROAD ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701192334",
            "telephone_number": "504-943-0070",
            "fax_number": "504-943-0072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 N BROAD ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701192334",
            "telephone_number": "504-943-0070",
            "fax_number": "504-943-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JARRETT ANN JOHNSON A PROFESSIONAL OPTOMETRY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-01",
        "last_updated": "2015-08-18",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JARRETT",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-943-0070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD,MPH"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1128-113T",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "LA",
            "license": "1128-133T",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1449652",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primary Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Orleans, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.