GARY E JOHNSON (NPI# 1275551848) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275551848 |
| Entity Type | Individual |
| Full Name | GARY E JOHNSON |
| Credential | OD |
| Practice Address |
3902 13th Ave S Ste 406 Fargo ND 58103-3357 |
| Mailing Address |
5092 Marion St S Fargo ND 58104-6050 |
| Practice Telephone | 7012779555 |
| Mailing Telephone | 7016408773 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2019-08-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
607 | ND | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578164265 | Gary L Johnson | Massage Therapist | 222 Columbus Ave Ste 220, San Francisco, CA 94133-4597 | 2020-11-08 |
| 1689146078 | Gary L Johnson | Marriage & Family Therapist | 1200 Cedar Ln, Tullahoma, TN 37388-2255 | 2018-12-22 |
| 1083085369 | Gary Johnson | Assisted Living Facility | 1539 W Avenue L12, Lancaster, CA 93534-6930 | 2015-10-13 |
| 1184063323 | Gary D Johnson | Pharmacist | 1897 E Fall View Dr, Sandy, UT 84093-7058 | 2013-06-20 |
| 1568709798 | Gary Lewis Johnson | Rehabilitation Practitioner | 9322 Dorrell Ln, 9322 Dorrell Lane, Las Vegas, NV 89149-0172 | 2013-01-08 |
| 1184997074 | Gary Wayne Johnson | Physical Therapist | 987 Nohunta Ct, Cincinnati, OH 45231-2518 | 2012-02-23 |
| 1518259811 | Gary A Johnson | Counselor | 4410 Arapahoe Ave Ste 205, Boulder, CO 80303-1155 | 2011-05-05 |
| 1285931923 | Gary David Johnson | Chiropractor | 413 W Morgan St, Duluth, MN 55811-4432 | 2011-02-15 |
| 1306156930 | Gary Anthony Johnson II | Private Vehicle | 1430 Dighton Ct, Virginia Beach, VA 23464-8624 | 2010-10-17 |
| 1417118217 | Gary Michael Johnson II | Audiologist | 7025 E Mcdowell Rd, Suite 1c, Scottsdale, AZ 85257-3328 | 2008-06-24 |
| Street Address |
3902 13TH AVE S STE 406 |
| City | FARGO |
| State | ND |
| Zip Code | 58103-3357 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659924843 | Amanda Hericks | Dentist | 1338 Gateway Drive S, Fargo, ND 58103 | 2019-07-17 |
| 1285298240 | Ann Louise Breen | Optometrist | Sanford Southpointe Eye Center & Optical, 2400 32nd Ave. S., Fargo, ND 58103 | 2019-04-25 |
| 1245706597 | Lisa Elaine Livingston | Counselor | 1337 14 and Half St. S., Fargo, ND 58103 | 2018-10-15 |
| 1528569662 | Misty Lynn Hagen | Counselor | 901 28th St. South, Suite B, Fargo, ND 58103 | 2018-02-23 |
| 1083133011 | Faith Homecare Professionals LLC | Home Health | 304 25th St S, Suite B, Fargo, ND 58103 | 2017-09-11 |
| 1982138749 | Matthew Troyer | Pharmacist | 2425 13th Ave, Fargo, ND 58103 | 2017-04-18 |
| 1801338504 | Amy Nguyen Christianson | Chiropractor | 1650 45th St S Ste 113, Fargo, ND 58103 | 2016-11-11 |
| 1245772359 | Andrea Marie Hanson | Nurse Practitioner | 2400 32nd Ave South, Fargo, ND 58103 | 2016-11-07 |
| 1831647940 | Abigail Carmen Burkett Vetter | Nurse Practitioner | 2928 University Dr S Suite 101, Fargo, ND 58103 | 2016-09-18 |
| 1013361302 | Nancy Knowlton | Speech-Language Pathologist | 3001 11th Ave S, Beyond Boundaries Speech-language, Fargo, ND 58103 | 2016-04-22 |
| Find all providers in zip 58103 | ||||
| Taxonomy Code | 152WC0802X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Specialization | Corneal and Contact Management |
| The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea’s ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. |
| Notes: Source: American Optometric Association [1/1/2009: added definition, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669494233 | Mark G Tufte | Optometrist | 1801 45th St S Ste G, Fargo, ND 58103-0801 | 2006-07-24 |
| 1811915499 | J Dennis Nelson | Optometrist | 737 Broadway N, Fargo, ND 58122-0001 | 2006-07-18 |
| 1942238951 | Sanford Clinic North | Optometrist | 2400 32nd Ave S, Fargo, ND 58103-5800 | 2006-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659477206 | Kyle D Krein | Optometrist | 404 Hwy 2 East, Devils Lake, ND 58301-0130 | 2006-09-14 |
| 1699191809 | Zachary Lemaster O.d. | Optometrist | 3601 32nd Ave S, Grand Forks, ND 58201-5911 | 2014-03-12 |
| 1124124623 | Mark A Moen | Optometrist | 404 Hwy 2 East, Devils Lake, ND 58301-0130 | 2006-09-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.