Active NPI
Shannon Johnson, P.T.
- Physical Therapist
- Greer, SC
National Provider Identifier
1104931435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5181
- Practice address
- 140 Executive Dr
Greer, SC 29651-1200 - Phone
- (864) 801-8706
- Fax
- (864) 848-7203
- NPI assigned
- Aug 19, 2006
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5181 | SC | Primary |
Addresses
Primary practice location
140 Executive Dr
Greer, SC 29651-1200
Mailing address
140 Executive Dr
Greer, SC 29651-1200
Phone (864) 801-8706
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
140 Executive Dr
Greer, SC 29651-1200
Phone (864) 801-8706
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5181 | SC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elite Integrated Therapy Centers, LLC | Physical Therapist | Current | Accepting new patients |
Locations
2005 E Greenville St
Ste 119
Anderson, SC 29621
Phone (864) 512-7023
1007 Grove Rd
#A
Greenville, SC 29605
140 Executive Dr
Greer, SC 29651
Phone (864) 801-8706
Organizations & group practices 1
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.
-
- Physical Therapist
- Greenville, SC
- NPI 1184673600
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614038400000",
"number": "1104931435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "140 EXECUTIVE DR",
"city": "GREER",
"state": "SC",
"postal_code": "296511200",
"telephone_number": "864-801-8706",
"fax_number": "864-848-7203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 EXECUTIVE DR",
"city": "GREER",
"state": "SC",
"postal_code": "296511200",
"telephone_number": "864-801-8706",
"fax_number": "864-848-7203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "SHANNON",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-19",
"last_updated": "2021-02-23",
"certification_date": "2021-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "5181",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Greer, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.