Rsjohnson OD PLLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

RSJOHNSON OD PLLC

Practice address

4240 Yellowstone Ave
Chubbuck, ID 83202-2420

Phone

(208) 241-9145

NPI assigned

Jun 25, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Ryan S Johnson, ODNPI 1184653404

Title

Owner

Phone

(208) 241-9145

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ryan Scott Johnson, O.D.

  • Optometrist
  • Chubbuck, ID
  • NPI 1184653404
  NPD Authorized official

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

{
    "created_epoch": "1624579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624579200000",
    "number": "1760052401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12482 DALLIN RD",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832025073",
            "telephone_number": "208-241-9145",
            "fax_number": "208-238-2069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4240 YELLOWSTONE AVE",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832022420",
            "telephone_number": "208-241-9145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RSJOHNSON OD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-25",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-24",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-241-9145",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184653403",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Liva Rigney-Cox
• Diana Rivas, PARAPROFESSIONAL
• Amber Romriell, M.S. CCC- SLP
• Brittney Romriell
• Tamara D Romriell, LPC
• Krista Buzzell Rudd, CCC-SLP
• Jennifer Sanderson, NP
• Mark Sapp
• Melaynia Sapp, PMHNP
• Scott Bradley Schaffer, MSN, APRN, FNP-C

• Optometrist in Chubbuck, ID
• Providers in Chubbuck, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.