Christopher David Johnson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2925ATI Issued in OR

Practice address

986 SE Uglow Street
Dallas, OR 97338

Phone

(503) 623-3538

Fax

(503) 623-8112

NPI assigned

Sep 7, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OR

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

Pacific University - College of Optometry, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Christopher D. Johnson OD, PC

  dba Mid-Valley Eyecare

  • Optometrist
  • Dallas, OR
  • NPI 1366517989
  Medicare reassignment NPD Authorized official
• Christopher D. Johnson OD, PC

  dba Mid Valley Eyecare

  • Optometrist
  • Monmouth, OR
  • NPI 1649778507
  NPD Authorized official
• Lifetime Vision Source of Lebanon LLC

  • Optometrist
  • Lebanon, OR
  • NPI 1710168877
  NPD (past)

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740383116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "986 SE UGLOW STREET",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "97338",
            "telephone_number": "503-623-3538",
            "fax_number": "503-623-8112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "986 SE UGLOW STREET",
            "city": "DALLAS",
            "state": "OR",
            "postal_code": "97338",
            "telephone_number": "503-623-3538",
            "fax_number": "503-623-8112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHRISTOPHER",
        "middle_name": "DAVID",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2925ATI",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYE MED VISION INSURANCE",
            "identifier": "212606",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DC7770",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "298499",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benjamin James, D.D.S.
• Kamielle James
• Jefferson Manor Residential Care, LLC (Jefferson Manor)
• Ying Jin
• James Henry Joerger, PSYCHOLOGIST
• Connie R Johnson, MS
• David Christopher Johnson, OD
• Judith Helen Johnson, RN
• Kenneth R Johnson Jr., 101YM0800X.
• Ellie Rosalee Jones

• Optometrist in Dallas, OR
• Providers in Dallas, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.