Shauntae McLamore Johnson, PHYSICIAN ASST CERTI

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

3675 J Dewey Gray Cir
Suite 300
Augusta, GA 30909-1868

Phone

(706) 863-9595

Fax

(888) 745-3917

NPI assigned

Mar 13, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588204800000",
    "number": "1104959931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3726",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309143726",
            "telephone_number": "706-863-9595",
            "fax_number": "888-745-3917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3675 J DEWEY GRAY CIR",
            "address_2": "SUITE 300",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309091868",
            "telephone_number": "706-863-9595",
            "fax_number": "888-745-3917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHAUNTAE",
        "middle_name": "MCLAMORE",
        "name_prefix": "Mrs.",
        "credential": "PHYSICIAN ASST CERTI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2020-04-30",
        "certification_date": "2020-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "004154",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert William Johnson, M.D.
• Savannah Johnson
• Scott Bradley Johnson
• Shakeitrice Stokes Johnson, MA, CCC-SLP
• Shaneka Johnson
• Shelly Johnson Jr.
• Stephanie Whitaker Johnson, MHS, OTR/L
• Taneshia Johnson
• Terrance Johnson, MD
• Theodore Samuel Johnson, M.D., PH.D.

• Surgical Physician Assistant in Augusta, GA
• Providers in Augusta, GA by specialty
• Surgical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2020; 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.