Sharon a Johnson FNP LLC
Organization Active NPI Family Nurse Practitioner · Rensselaer, IN
NPI 1124589957 · NPPES record last updated Oct 31, 2025
Key facts
- NPI
- 1124589957
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- Legal business name
- SHARON A JOHNSON FNP LLC
- Practice address
- 124 W Washington St
Rensselaer, IN 47978-2820 - Phone
- (219) 866-8655
- Fax
- (219) 866-0803
- NPI assigned
- Mar 26, 2019
- Organization subpart
- No
Authorized official
- Name
- Samantha Laurel Moran
- Title
- Practice Manager
- Phone
- (219) 866-4135
Practitioners 2
-
Debra L Drescher, NP
-
Sharon A Johnson, FNP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 15D0362552 | Clinic of Family Medicine | Certificate of waiver | Jan 30, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190514000364 | IN | Part B Supplier - Clinic/Group Practice | 0941543094 |
Receives reassigned benefits from 2 practitioners Practice locations: Rensselaer, IN |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner |
363LF0000X | Yes |
Addresses
Primary practice location
124 W Washington St
Rensselaer, IN 47978-2820
Mailing address
124 W Washington St
Rensselaer, IN 47978-2820
Phone (219) 866-8655
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300096893 | Medicaid | IN |
Other names
- Clinic of Family Medicine
Other providers in Rensselaer, IN
- Laura Mae Rozhon
- Donald Lowell Rusk
- Ryan and Ryan
- Jeffrey Edward Sampson
- Kristina M Schoon
- Sheets Family Practice P.C. Inc.
- Patrick J Sheets
- Stephanie Ann Shields
- Denise A Snyder
- Sonus-USA, Inc.
All providers in Rensselaer, IN · Family Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 31, 2025. 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.
- 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.