Active NPI
Shawn Johnson, DC
- Chiropractor
- Fresno, CA
National Provider Identifier
1093852170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC 20638
- Practice address
- 5430 N Palm Ave Ste 112
Fresno, CA 93704-1900 - Phone
- (559) 431-6874
- NPI assigned
- Jan 30, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC 20638 | CA | Primary |
Addresses
Primary practice location
5430 N Palm Ave Ste 112
Fresno, CA 93704-1900
Mailing address
5430 N Palm Ave Ste 112
Fresno, CA 93704-1900
Phone (559) 431-6874
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC 20638 | CA | MD | Chiropractor |
| 20638 | CA | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1093852170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5430 N PALM AVE STE 112",
"city": "FRESNO",
"state": "CA",
"postal_code": "937041900",
"telephone_number": "559-431-6874"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5430 N PALM AVE STE 112",
"city": "FRESNO",
"state": "CA",
"postal_code": "937041900",
"telephone_number": "559-431-6874"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "SHAWN",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC 20638",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.