Individual provider Active NPI

Cherie Ann Johnson, OD

  • Optometrist
  • Olathe, KS
National Provider Identifier
1972596252
Registry record updated Dec 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
14833 Issued in KS
Practice address
15710 W 135TH St
Olathe, KS 66062-1510
Phone
(816) 478-1230
Fax
(816) 350-4747
NPI assigned
Aug 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T03323 MO
Optometrist 152W00000X 14833 KS Primary

Addresses

Primary practice location

15710 W 135TH St
Olathe, KS 66062-1510

Mailing address

4801 S Cliff Ave
Suite 100
Independence, MO 64055-7015
Phone (816) 478-1230

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
I20051029000317 KS Practitioner - Optometry 3971520834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Care LLCGroup PAC ID 4385544600, 49 clinicians

Practice addresses (Care Compare)

11500 Granada St
Leawood, KS 66211-1453
Phone (816) 478-1230

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14833KSMDOptometrist
T03323MOMDOptometrist
1483KSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care, LLC Optometrist CurrentSince Aug 1, 2004 Accepting new patients
Eye Care, LLC Optometrist CurrentSince Aug 1, 2004 Accepting new patients
Eye Care LLC Optometrist Past Accepting new patients

Locations

11500 Granada St
Leawood, KS 66211
Phone (816) 350-6902

15710 W 135th St
Olathe, KS 66062

4801 S Cliff Ave
Ste 100
Independence, MO 64055
Phone (816) 350-4536

4741 S Cochise Dr
Independence, MO 64055
Phone (816) 542-2849

Interoperability endpoints

  • Direct secure messaging: cjohnson@direct.dvc.nextgenshare.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1972596252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 S CLIFF AVE",
            "address_2": "SUITE 100",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640557015",
            "telephone_number": "816-478-1230",
            "fax_number": "816-478-4413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15710 W 135TH ST",
            "city": "OLATHE",
            "state": "KS",
            "postal_code": "660621510",
            "telephone_number": "816-478-1230",
            "fax_number": "816-350-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHERIE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-23",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T03323",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "14833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olathe, KS

Sources for this page

Verify at the official NPI Registry.