Shane Johnson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904013744 Issued in VA

Practice address

85 Sangers LN
Staunton, VA 24401-6712

Phone

(540) 213-7566

Fax

(540) 887-3245

NPI assigned

Mar 14, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley Community Services BoardGroup PAC ID 3678466398, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Valley Community Services Board

  • Community/Behavioral Health Agency
  • Staunton, VA
  • NPI 1649205212
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1063160620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 SANGERS LN",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "244016712",
            "telephone_number": "540-213-7566",
            "fax_number": "540-887-3245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 SANGERS LN",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "244016712",
            "telephone_number": "540-213-7566",
            "fax_number": "540-887-3245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHANE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-14",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904013744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "mdoyle@vcsb.org",
            "affiliation": "N",
            "endpointDescription": "Credentialing email",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "none",
            "address_1": "85 Sangers Ln",
            "city": "Staunton",
            "state": "VA",
            "country_code": "US",
            "postal_code": "244016712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Diana Althea Jensen, MD
• Karen Marie Jessick, LPC
• John R. Roller and Associates
• Frank J Johnson II, MD
• Rodriquez Johnson
• Shannon Johnson
• Erin Johnston
• Alexander Jones, MS,
• Andrew Jones, PHD
• Michelle Jones

• Clinical Social Worker in Staunton, VA
• Providers in Staunton, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.