SAMUEL D JOHNSON OD PLLC
NPI 1417446097
Optometrist in Fairmont, NC

Q: What is Samuel D Johnson Od PLLC's NPI number?

The NPI number for Samuel D Johnson Od PLLC is 1417446097. It was assigned to this organization in the NPPES registry on May 9, 2018.

Q: What is Samuel D Johnson Od PLLC's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Active since May 09, 2018

204 IONA ST, FAIRMONT, NC 28340(910) 628-8316(910) 628-5642 Get Directions Write a Review

NPPES record last updated: May 9, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Samuel D Johnson Od Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMUEL D JOHNSON OD PLLC (NPI 1417446097) is a healthcare organization registered as an optometrist in Fairmont, North Carolina and active in the NPI registry since May 2018. The organization lists Sameul Johnson, Owner, as its authorized official.

NPPES Registry Identity

NPI1417446097

Entity TypeOrganization

Primary Taxonomy152W00000X

Legal Business NameSAMUEL D JOHNSON OD PLLC

Location Address204 IONA STFairmont, NC 28340-1616

Mailing AddressPo Box 648Fairmont, NC 28340-0648 · (910) 628-8316 · Fax (910) 628-5642

Phone(910) 628-8316

Fax(910) 628-5642

Organization SubpartNo

Authorized OfficialSameul JohnsonOwner · (910) 628-8316

Enumeration DateMay 9, 2018

✔ NPI 1417446097 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

License✔ Licensed in NC · 2337

Definition

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.

204 IONA ST, Fairmont, NC 28340

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samuel D Johnson Od Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 3 clinicians reassign Medicare billing to Samuel D Johnson Od PLLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Lionel Chamberlain, OD

Optometry

NPI 1225039340

204 IONA ST
Fairmont, NC 28340

(910) 268-8316

✔ PECOS✔ Accepts MedicareSame address

Harold Herring, OD, PA

Optometry

NPI 1053312181

204 IONA ST
Fairmont, NC 28340

(910) 628-8316

✔ PECOS✔ Accepts MedicareSame address

Samuel Johnson, O.D.

Optometry

NPI 1962838565

204 IONA ST
Fairmont, NC 28340

(910) 628-8316

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Samuel D Johnson Od PLLC's NPI number?

The NPI number for Samuel D Johnson Od PLLC is 1417446097. It was assigned to this organization in the NPPES registry on May 9, 2018.

Where is Samuel D Johnson Od PLLC located?

Samuel D Johnson Od PLLC is located at 204 Iona St, Fairmont, NC 28340. The listed phone number is (910) 628-8316.

What is Samuel D Johnson Od PLLC's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Samuel D Johnson Od PLLC enrolled in Medicare?

Yes. Samuel D Johnson Od PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Samuel D Johnson Od PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Optometry, reassign their Medicare billing to Samuel D Johnson Od PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Samuel D Johnson Od PLLC accept?

Health plans from Blue Cross and Blue Shield of NC list Samuel D Johnson Od PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Samuel D Johnson Od PLLC was last updated on May 9, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.