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Deactivated NPI 1336130772 Deactivated / Inactive NPI Male Practitioner

Dr. George Kenneth Johnson , OD

Optometrist • Phoenix, AZ

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. George Johnson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 03, 2005
NPI Deactivation Date July 02, 2021
Total Practice Duration ~16 Years of Practice (2005 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. George Johnson, OD was a registered Optometrist practicing in Phoenix, AZ. Throughout an active medical career spanning 16 years, Dr. Johnson provided care at the practice location at 4025 W BELL RD until profile deactivation on 2021-07-02.

Historical Medicare Part B clinical services included established patient complete exam of visual system, removal of cataract with insertion of lens, new patient complete exam of visual system. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

4025 W Bell Rd
Suite 10

Phoenix, AZ 850532750

Telephone 6029784025
Fax 6028437101
Associated Practice Facility / Clinic
🏢 Mg Pharmacy Facility NPI 1821009499

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Phoenix, AZ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 18.8 Yrs
State Avg: 20.2 Yrs
Regional Practice Density
255 Specialists

Practicing in Phoenix, AZ (1373 Statewide)

Telehealth Adoption Rate
0.4% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2021)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
92014 Established patient complete exam of visual system
20 20 $104.00 $104.00

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License AZ 117

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

11 Associated Practitioners
NPI 1114034188

DDSMSPC

Dr. Michael Harper , DDS

Dentist - General Practice

NPI 1134183536

Doctor of Dental Surgery

Dr. Clark Jones , DDS

Dentist - Orthodontics and Dentofacial Orthopedics

NPI 1154568095

Doctor of Dental Surgery

Dr. Donald Johnson , DMD

Dentist - Oral and Maxillofacial Surgery

NPI 1164516753

Doctor of Dental Medicine

Dr. Jerome Schweikert , DDS

Dentist - Oral and Maxillofacial Surgery

NPI 1205894490

Doctor of Dental Surgery

Bonny Wager Tabah , RD

Dietitian, Registered

NPI 1649437294

Registered Dietitian

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated July 02, 2021

Record deactivated on July 02, 2021

NPI Profile Active August 27, 2008

NPI status registered as active in NPPES database

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Updated Practice Location August 27, 2008

Registered at 4025 W BELL RD, SUITE 10, PHOENIX, AZ 850532750 (Tel: 6029784025)

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Updated Business Mailing Address August 27, 2008

Registered at 4025 W BELL RD, SUITE 10, PHOENIX, AZ 850532750 (Tel: 6029784025)

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Provider Name / Credentials Updated August 27, 2008

Recorded as GEORGE JOHNSON, O.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 27, 2008

Optometrist (License #117 in AZ)

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Initial NPI Registration & Enumeration November 03, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1336130772
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 03, 2005
Last Update: August 27, 2008
Deactivation Date: July 02, 2021

Mailing Address

4025 W Bell Rd, Suite 10

Phoenix, AZ 850532750

Phone: 6029784025

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.