Amanda Steele Johnson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1822 Issued in NC

Practice address

110 Capcom Ave
Wake Forest, NC 27587-6531

Phone

(919) 391-7224

NPI assigned

Aug 31, 2005

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NC

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

Southern College of Optometry, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of North Carolina PLLCGroup PAC ID 6608019096, 167 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.

• Myeyedr Optometry of North Carolina, PLLC

  dba MyEyeDr

  • Optometrist
  • Charlotte, NC
  • NPI 1023183563
  Medicare reassignment Care Compare group
• Myeyedr Optometry of North Carolina, PLLC

  dba MyEyeDr.

  • Optometrist
  • Raleigh, NC
  • NPI 1518507904
  NPD
• Myeyedr Optometry of North Carolina

  dba MyEyeDr

  • Optometrist
  • Charlotte, NC
  • NPI 1700851045
  NPD (past)

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1831182294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CAPCOM AVE",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275876531",
            "telephone_number": "919-391-7224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2075 Renaissance Park Pl",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275132263",
            "country_code": "US",
            "telephone_number": "919-391-7224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AMANDA",
        "middle_name": "STEELE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-31",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89093FT",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS",
            "identifier": "093FT",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410048137",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Si Eun Jeon, D. D. S
• Jess Beu Integrative Therapy
• Joanna Gamble DMD, PLLC
• John F. Kubiak, LMFT, PLLC
• Wendell Clavonn John, RN, MSN, FNP-C
• Deshah Jalen Johnson, NP
• Sarah Ann Johnson, LMFTA
• Tiara Jalynn Johnson, RPH
• Elizabeth Barnes Jolley, PHD CCC-SLP
• Renee Stein Jolly, MS, CCC-SLP

• Optometrist in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; 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.