Healthcare Provider Details

I. General information

NPI: 1922140805
Provider Name (Legal Business Name): BARBRA RAYE JOHNSON O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 09/27/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5530 WISCONSIN AVE STE 1209
CHEVY CHASE MD
20815-4301
US

IV. Provider business mailing address

11611 GLEN RD.
POTOMAC MD
20854
US

V. Phone/Fax

Practice location:
  • Phone: 301-272-9930
  • Fax:
Mailing address:
  • Phone: 301-983-9697
  • Fax: 301-983-9697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTAO824
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: