Shannon Marie Johnson, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Belvidere, TN
NPI 1114435484 · NPPES record last updated Feb 3, 2018
Key facts
- NPI
- 1114435484
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 23682 (TN)
- Practice address
- 120 Horton LN
Belvidere, TN 37306-2109 - Phone
- (931) 308-6537
- Fax
- (931) 308-6537
- NPI assigned
- Jan 19, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 25
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fast Pace Medical Clinic PLLC
Practice addresses (Care Compare)
100 E Tennessee St
Collinwood, TN 38450
Phone (931) 724-9000
2401 Decherd Blvd
Winchester, TN 37398-1164
Phone (615) 988-1571
4696 Nashville Hwy
Chapel Hill, TN 37034-2110
Phone (931) 364-5321
600 N Jackson St
Tullahoma, TN 37388-3542
Phone (615) 988-1571
Hospital & facility affiliations
- Panola Medical Center
- Southern Tennessee Regional Health System Winchest
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in TN, AL, KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180817002012 | TN | Practitioner - Nurse Practitioner | 7012266414 | Reassigns benefits to 7 organizations |
| I20220819001785 | AL | Practitioner - Nurse Practitioner | 7012266414 | Reassigns benefits to 1 organization |
| I20231101003314 | KY | Practitioner - Nurse Practitioner | 7012266414 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fast Pace Medical Clinic PLLC | Current |
Accepting new patients | |
| Upperline Healthcare, PC | Current |
Accepting new patients | |
| Signify Health Medical Associates, PLLC | Current |
Accepting new patients | |
| Russellville Hospital Inc | Current | Accepting new patients | |
| Fast Pace Medical Clinic PLLC | Current |
Accepting new patients | |
| Healthcare Plus Limited Liability Company | Current |
Accepting new patients | |
| Russellville Hospital Inc | Current |
Accepting new patients | |
| Signify Health, LLC | Current |
Accepting new patients | |
| Wound Management Specialists, LLC | Current |
Accepting new patients | |
| Upperline Healthcare, PC | Current |
Accepting new patients | |
| Curana Health of Tennessee LLC | Family | Current |
Accepting new patients |
| Elk River Physicians Group, PLLC | Past |
Accepting new patients |
Locations
4000 Eagle Point Corporate Dr
Birmingham, AL 35242
Phone (205) 317-0280
15225 Highway 43
Ste I
Russellville, AL 35653
Phone (256) 331-2700
312 S 4th St
Ste 700
Louisville, KY 40202
Phone (502) 628-5023
778 Liberty Rd
Flowood, MS 39232
Phone (601) 914-9620
7348 E Brainerd Rd
Chattanooga, TN 37421
Phone (205) 822-8038
300 Montvue Rd
Knoxville, TN 37919
Phone (818) 613-6769
5865 Ridgeway Center Pkwy
Memphis, TN 38120
Phone (901) 219-1295
6019 Walnut Grove Rd
Memphis, TN 38120
Phone (901) 226-3190
910 New Highway 68
Sweetwater, TN 37874
Phone (423) 836-9304
600 N Jackson St
Tullahoma, TN 37388
Phone (931) 563-5469
1705 W Reelfoot Ave
Union City, TN 38261
Phone (731) 599-1102
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 23682 | TN | Yes |
Addresses
Primary practice location
120 Horton LN
Belvidere, TN 37306-2109
Mailing address
1509 Old Cowan Rd
Winchester, TN 37398-1913
Phone (931) 962-1004
Other providers in Belvidere, TN
All providers in Belvidere, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 3, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.