Jessalyn Ilene Johnson
Individual provider Active NPI Optician · Sparta, WI
NPI 1740105337 · NPPES record last updated Aug 12, 2026
Key facts
- NPI
- 1740105337
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optician 156FX1800X
- Practice address
- 1600 W Wisconsin St
Sparta, WI 54656-2242 - Phone
- (608) 269-4351
- NPI assigned
- Aug 12, 2026
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | WI | Yes |
Addresses
Primary practice location
1600 W Wisconsin St
Sparta, WI 54656-2242
Mailing address
1600 W Wisconsin St
Sparta, WI 54656-2242
Phone (608) 269-4351
Other practice location 1
611 Wi-54
Black river falls, WI 54615
Phone (715) 284-1592
Other providers in Sparta, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.