Individual provider Active NPI

John T Davis, OD

  • Optometrist
  • Overland Park, KS
National Provider Identifier
1891861894
Registry record updated Apr 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1372 Issued in KS
Practice address
10120 W 119TH St
Overland Park, KS 66213
Phone
(913) 339-9090
Fax
(913) 339-6417
NPI assigned
Nov 28, 2006
Last updated
Apr 20, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1372 KS Primary

Addresses

Primary practice location

10120 W 119TH St
Overland Park, KS 66213

Mailing address

10120 W 119TH St
Overland Park, KS 66213
Phone (913) 339-9090

Other identifiers 11

IdentifierTypeStateIssuer
P00126436OtherKSRR MEDICARE FOR EYE ASSOCIATES OF OVERLAND PARK
KA1109001OtherKSMEDICARE PART B FOR EYE ASSOCIATES OF LEAWOOD
R183435OtherKSMEDICARE PART B FOR EYE ASSOCIATES OF OLATHE
19196025OtherMOBCBKSC FOR EYE ASSOCIATES OF OLATHE
R193435OtherKSMEDICARE PART B FOR EYE ASSOCIATES OF OVERLAND PARK
19196015OtherMOBCBSKC FOR EYE ASSOCIATES OF OVERLAND PARK
4613812OtherKSAETNA
P00109862OtherKSRR MEDICARE FOR EYE ASSOCIATES OF OLATHE
19196045OtherMOBCBSKC FOR EYE ASSOCIATES OF LEAWOOD
R173435OtherKSMEDICARE PART B FOR EYE ASSOCIATES OF SHAWNEE
19196035OtherMOBCBSKC FOR EYE ASSOCIATES OF SHAWNEE

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20070810000794 KS Practitioner - Optometry 3779555941 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Associates of Olathe PAGroup PAC ID 4284606492, 9 clinicians

Practice addresses (Care Compare)

15257 W 135TH St
Olathe, KS 66062-1534
Phone (913) 780-9696

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Associates of Leawood PA Optometrist CurrentSince Dec 1, 2007 Accepting new patients
Eye Associates of Olathe PA Optometrist CurrentSince Jul 27, 2003 Accepting new patients
Eye Associates of Shawnee PA Optometrist CurrentSince Jul 27, 2003 Accepting new patients
Eye Associates of Overland Park PA Optometrist CurrentSince Jul 27, 2003 Accepting new patients
Eye Associates of South Overland Park Optometrist CurrentSince Aug 3, 2021 Accepting new patients
Eye Associates of Prairie Village,PA Optometrist CurrentSince Jul 1, 2012 Accepting new patients
Eye Associates of North Overland Park Optometrist CurrentSince Jul 1, 2022 Accepting new patients
Eye Associates of South Olathe Optometrist CurrentSince May 1, 2014 Accepting new patients

Locations

15257 W 135th St
Olathe, KS 66062
Phone (913) 780-9696

16021 S Bradley Dr
Olathe, KS 66062
Phone (913) 339-9090

10120 W 119th St
Overland Park, KS 66213
Phone (913) 339-9090

15069 Nall Ave
Overland Park, KS 66223
Phone (913) 825-2600

8029 W 159th St
Overland Park, KS 66223
Phone (913) 339-9090

8925 Metcalf Ave
Overland Park, KS 66212
Phone (913) 261-9985

7632 State Line Rd
Prairie Vlg, KS 66208
Phone (913) 642-5000

15951 W 65th St
Shawnee, KS 66217
Phone (913) 268-9190

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240185600000",
    "number": "1891861894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10120 W 119TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "66213",
            "telephone_number": "913-339-9090",
            "fax_number": "913-339-6417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10120 W 119TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "66213",
            "telephone_number": "913-339-9090",
            "fax_number": "913-339-6417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JOHN",
        "middle_name": "T",
        "name_prefix": "Mr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2009-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "1372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE FOR EYE ASSOCIATES OF OVERLAND PARK",
            "identifier": "P00126436",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B FOR EYE ASSOCIATES OF LEAWOOD",
            "identifier": "KA1109001",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B FOR EYE ASSOCIATES OF OLATHE",
            "identifier": "R183435",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBKSC FOR EYE ASSOCIATES OF OLATHE",
            "identifier": "19196025",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B FOR EYE ASSOCIATES OF OVERLAND PARK",
            "identifier": "R193435",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSKC FOR EYE ASSOCIATES OF OVERLAND PARK",
            "identifier": "19196015",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4613812",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE FOR EYE ASSOCIATES OF OLATHE",
            "identifier": "P00109862",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSKC FOR EYE ASSOCIATES OF LEAWOOD",
            "identifier": "19196045",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B FOR EYE ASSOCIATES OF SHAWNEE",
            "identifier": "R173435",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSKC FOR EYE ASSOCIATES OF SHAWNEE",
            "identifier": "19196035",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.