Johnson Vision Development Center, LLC
NPI 1235401514ActiveOrganization· Optometrist, Pediatrics· Jackson, TN
Optometrist, Pediatrics in Jackson, Tennessee, registered in NPPES in February 2012. The authorized official on file is Paula Johnson-Wyatt, OD, Owner/Optometrist. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1235401514 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 2, 2012 |
| Last updated in NPPES | Sep 25, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist, Pediatrics Primary | 152WP0200X | — | — |
| Optometrist, Vision Therapy | 152WV0400X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (TN) |
|---|
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