Shawntae Johnson, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN122825 Issued in OH

Practice address

21770 Fuller Ave
Euclid, OH 44123-2763

Phone

(216) 326-1834

NPI assigned

Dec 5, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Families Affair Homecare

  • Pediatric Skilled Nursing Facility
  • Euclid, OH
  • NPI 1740558741
  NPD (past) Authorized official

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

{
    "created_epoch": "1323043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323043200000",
    "number": "1093083024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21770 FULLER AVE",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441232763",
            "telephone_number": "216-326-1834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21770 FULLER AVE",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441232763",
            "telephone_number": "216-326-1834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHAWNTAE",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-05",
        "last_updated": "2011-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN122825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1740558741",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Johnson
• Nicol S Johnson
• Rasheda Yevette Johnson, RN
• Roderic Kenneth Johnson, CDCA
• Samarra Johnson
• Shoshawnna Johnson
• Steven Lewis Johnson, LPTA
• Timmi Evana Johnson
• Johnston Drug Inc
• Muhammad Jokhio, MD

• Licensed Practical Nurse in Euclid, OH
• Providers in Euclid, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.