Stephanie R. Johnson, O.D.

Primary specialty

Vision Therapy OptometristTaxonomy code 152WV0400X

License

046007055 Issued in IL

Practice address

5401 S Wentworth Ave Ste 14B
Chicago, IL 60609-6300

Phone

(773) 924-5292

Fax

(773) 373-3548

NPI assigned

Feb 1, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Illinois College of Optometry at Chicago, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Plano Optometrics LTDGroup PAC ID 4789672650, 2 clinicians

Practice addresses (Care Compare)

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.

• Plano Optometrics LTD

  • Optometrist
  • Chicago, IL
  • NPI 1710106299
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1992843007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 S WENTWORTH AVE STE 14B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606096300",
            "telephone_number": "773-924-5292",
            "fax_number": "773-373-3548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 S WENTWORTH AVE STE 14B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606096300",
            "telephone_number": "773-924-5292",
            "fax_number": "773-373-3548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "STEPHANIE",
        "middle_name": "R.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "46-7055",
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "IL",
            "license": "046007055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0046007055",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelby Louise Johnson, MD
• Sherese Johnson
• Sheretta Therese Johnson
• Stephanie D Johnson, ARNP, FNP-C
• Stephanie Marie Johnson, PSYD
• Sukina T Johnson, PHARM.D
• Sydney Paige Johnson
• Tahnee Johnson
• Tasha Johnson
• Tashanda Johnson

• Vision Therapy Optometrist in Chicago, IL
• Providers in Chicago, IL by specialty
• Vision Therapy Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; 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.