DR. WALLACE SCOTT JOHNSON (NPI# 1346209020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346209020 |
| Entity Type | Individual |
| Full Name | DR. WALLACE SCOTT JOHNSON |
| Credential | O.D. |
| Practice Address |
702 10th St Worthington MN 56187-2767 |
| Mailing Address |
Po Box 726 Worthington MN 56187-0726 |
| Practice Telephone | 5073765535 |
| Practice Fax Number | 5073764805 |
| Mailing Telephone | 5073765535 |
| Mailing Fax Number | 5073764805 |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2015-03-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 2196 | MN | Eye and Vision Services Providers |
| N | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
2196 | MN | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | MPIN | 63372 | 01 |
| MN | 970525200 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932355229 | Wallace B Johnson | Dentist | West Lake Road, Mayville, NY 14757-0126 | 2008-08-18 |
| 1639341076 | Wallace Emanuel Johnson | Orthopaedic Surgery | 273 Leeward Ct, Detroit, MI 48207-5053 | 2008-03-26 |
| 1659480838 | Wallace Allen Johnson Jr. | Pharmacist | 933 Old Rockford St, Suite 3, Mount Airy, NC 27030-5356 | 2006-08-30 |
| 1902833619 | Wallace E Johnson | Internal Medicine | 800 Ayrault Rd Ste 200, Fairport, NY 14450-8941 | 2006-06-27 |
| 1043253867 | Wallace R Johnson | Internal Medicine | 22 S Greene St, Baltimore, MD 21201-1590 | 2006-06-13 |
| Street Address |
702 10TH ST |
| City | WORTHINGTON |
| State | MN |
| Zip Code | 56187-2767 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306452131 | Worthington Eye Clinic, LLC | Optometrist | 702 10th St, Worthington, MN 56187-2767 | 2020-09-17 |
| 1174077275 | Avera Mckennan | Optometrist | 702 10th St, Worthington, MN 56187-2767 | 2016-08-08 |
| 1417378555 | Avera Marshall | Optometrist | 702 10th St, Worthington, MN 56187-2767 | 2013-12-16 |
| 1164791919 | Lezlie Pearl Jones | Optometrist | 702 10th St, Worthington, MN 56187-2767 | 2011-12-23 |
| 1184700825 | Johnson Eye Clinic, P.a | Optometrist | 702 10th St, Worthington, MN 56187-2767 | 2006-10-27 |
| 1821023979 | Roger Dean Johnson | Optometrist | 702 10th St, Worthington, MN 56187-2767 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316224363 | Paul Michael Carlson | Dentist | 507 South Shore Drive, Worthington, MN 56187 | 2011-11-04 |
| 1912216540 | Nobles County Jail | Clinic/Center | 1530 Airport Road, Worthington, MN 56187 | 2010-09-30 |
| 1306984539 | Edward Thomas Mcniece | Dentist | 1027 Second Ave, Worthington, MN 56187 | 2007-02-01 |
| 1053338780 | Diagnostic Radiologic Imaging Pa | Radiology | 1607 N Mcmillan St, Ste 1, Worthington, MN 56187 | 2006-07-17 |
| 1427014232 | Scott James Hoffman | Podiatrist | 1205 Ryans Road, Worthington, MN 56187 | 2006-04-21 |
| 1588654404 | Jason Coy Turner | Pharmacist | 511 10th St, Worthington, MN 56187 | 2005-10-22 |
| 1518433879 | Nicole Block | Nurse Practitioner | 1680 Diagonal Rd, Worthington, MN 56187 | 2018-10-15 |
| 1033423322 | Rachael R Dekker | Nurse Practitioner | 1018 6th Ave, Worthington, MN 56187 | 2010-07-29 |
| 1417196601 | Jonathan Gabriel Eli-phillips | Obstetrics & Gynecology | 1018 6th Ave, Worthington, MN 56187 | 2009-02-11 |
| 1174716245 | Sanford Clinic | Radiology | 1018 6th Ave, Worthington, MN 56187 | 2007-08-22 |
| Find all providers in zip 56187 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326124199 | James B Albright | Optometrist | 89 E Wilson Bridge Rd, Worthington, OH 43085-2379 | 2006-10-27 |
| 1437250164 | Specnique By Stephanie Thier Od PC | Optometrist | 1607 Mcmillan St, Worthington, MN 56187-2802 | 2006-09-26 |
| 1528079498 | Clear Image Eyecare, LLC | Optometrist | 6877 N High St, Suite 100, Worthington, OH 43085-2516 | 2006-08-10 |
| 1306898630 | Scott Joseph Haas | Optometrist | 1755 N Humiston Ave, Worthington, MN 56187-1757 | 2006-05-16 |
| 1306452131 | Worthington Eye Clinic, LLC | Optometrist | 702 10th St, Worthington, MN 56187-2767 | 2020-09-17 |
| 1174077275 | Avera Mckennan | Optometrist | 702 10th St, Worthington, MN 56187-2767 | 2016-08-08 |
| 1831503630 | Jonathan Jay Lytle | Optometrist | 89 E Wilson Bridge Rd, Worthington, OH 43085-6315 | 2014-06-19 |
| 1417378555 | Avera Marshall | Optometrist | 702 10th St, Worthington, MN 56187-2767 | 2013-12-16 |
| 1902170319 | Erin M. Papp, Od, LLC | Optometrist | 7227 N High St, Suite 255, Worthington, OH 43085-2574 | 2012-03-02 |
| 1164791919 | Lezlie Pearl Jones | Optometrist | 702 10th St, Worthington, MN 56187-2767 | 2011-12-23 |
| Find all providers in WORTHINGTON | ||||
| City | WORTHINGTON |
| Zip Code | 56187 |
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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.