Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Shane M Johnston, OD

Individual provider Sports Vision Optometrist · NPI 1356791545

Dr. Shane M Johnston, OD is an Optometry in Mesa, Arizona. Qualified in 2016, 10 years ago. Practices with Kirk T Reed O D P C, a 2-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
10
Licensed in
AZ
In the registry since
2016
Specialties on file
2
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

1940 S Country Club Dr Ste 102
Mesa, AZ 85210-6042
Phone: (480) 834-6367
Fax: (480) 834-7277
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 2108 (AZ)
Sports Vision Optometrist Taxonomy 152WS0006X · Licence 2108 (AZ)

Record details

NPI number1356791545
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorNo
NPI enumeratedJune 17, 2016
Last updated in NPPESJune 5, 2026
Certification dateJune 5, 2026
Mailing address8614 Westwood Center Dr Fl 9, Vienna, VA 22182-2442

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Kirk T Reed O D P C — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount