Shannon Marie Johnson, PTA, BS

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

06005493A Issued in IN

Practice address

2304 Dubois Dr
Warsaw, IN 46580-3213

Phone

(574) 267-3500

NPI assigned

Jul 24, 2017

Last updated

Jul 24, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fort Wayne Orthopaedics, LLC

  • Durable Medical Equipment & Medical Supplies
  • Gas City, IN
  • NPI 1699425082
  NPD (past)
• Peak Performance Orthopedic & Sports Physical Therapy, P.C.

  • Physical Therapist
  • Warsaw, IN
  • NPI 1205900313
  NPD (past)

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

{
    "created_epoch": "1500854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500854400000",
    "number": "1154844942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2304 DUBOIS DR",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803213",
            "telephone_number": "574-267-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2304 DUBOIS DR",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803213",
            "telephone_number": "574-267-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "credential": "PTA, BS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-24",
        "last_updated": "2017-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06005493A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Johnson Chiropractic, Inc
• Johnson Memorial Hospital (Miller's Merry Manor)
• Matthew G Johnson, DC
• Nathaniel Lee Johnson
• Rachel L Johnson, O.D.
• Carmen Johnston, PA
• John W Jones, DDS
• Karly Kristine Jones
• Rachel C Jones, FNP
• Stacey M Jones

• Physical Therapy Assistant in Warsaw, IN
• Providers in Warsaw, IN by specialty
• Physical Therapy Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2017; 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.