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Active NPI 1710580436 Individual Practitioner Male Practitioner

Kenneth N Johnson

Technician/Technologist - Optician • Niantic, CT

Professional Overview & Biography Verified Profile Summary

Kenneth Johnson is a registered healthcare professional specializing in Technician/Technologist - Optician in Niantic, CT. Practice services are available at 179 FLANDERS RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

179 Flanders Rd

Niantic, CT 063571206

Telephone 8606910279
Associated Practice Facility / Clinic
🏢 Guardian Health Center, Pa Facility NPI 1184839128

Specialty Benchmarks & Practice Insights

Comparative analytics for Technician/Technologist - Optician in Niantic, CT

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 19.0 Yrs
Regional Practice Density
2 Specialists

Practicing in Niantic, CT (251 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2020-11-17
Technician/Technologist - Optician Primary Specialty

NUCC Taxonomy Code: 156FX1800X

State License CT CT0001217

Opticians help fit eyeglasses and contact lenses, following prescriptions from Ophthalmologists and Optometrists. They also help customers decide which eyeglass frame or contact lenses to buy.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
1326280512 (CT)
Medicaid State Provider ID
0001217 (CT)

Practice Associates & Co-Workers

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

1 Associated Practitioners
Dr. Troy Frazer , DO

Family Medicine

NPI 1689775918

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

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

6 Historical Events
✅
NPI Profile Active November 17, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location November 17, 2020

Registered at 179 FLANDERS RD, NIANTIC, CT 063571206 (Tel: 8606910279)

📍
Updated Business Mailing Address November 17, 2020

Registered at 179 FLANDERS RD, NIANTIC, CT 063571206 (Tel: 8607390279)

👤
Provider Name / Credentials Updated November 17, 2020

Recorded as KENNETH JOHNSON

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 17, 2020

Technician/Technologist (License #CT0001217 in CT)

🟢
Initial NPI Registration & Enumeration November 17, 2020

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: 1710580436
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 17, 2020
Last Update: November 17, 2020
Sole Proprietor: No
Update or Correct Profile

Mailing Address

179 Flanders Rd

Niantic, CT 063571206

Phone: 8607390279

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.