Shavaun Johnson, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

2024022030 Issued in MO

Practice address

21168 E Ocotillo Rd # 1045
Queen Creek, AZ 85142-8175

Phone

(623) 265-6220

Fax

(866) 491-7389

NPI assigned

Dec 18, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ, MO2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Jewish Family & Children'S Service

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1023174455
  Medicare reassignment NPD
• Southwest Behavioral Health Services Inc

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1144384389
  Medicare reassignment NPD
• Mercy Clinic Adult Hospitalists - St. Louis, LLC

  • Internal Medicine Physician
  • Saint Louis, MO
  • NPI 1841235108
  Medicare reassignment NPD
• Mercy Clinic Adult Hospitalists - Washington, LLC

  • Hospitalist Physician
  • Washington, MO
  • NPI 1891943429
  Medicare reassignment NPD
• Mercy Clinic Adult Hospitalists- Jefferson, LLC

  • Internal Medicine Physician
  • Festus, MO
  • NPI 1083052492
  Medicare reassignment NPD
• St Anthonys Physician Organization Hospitalist Services, L.C.

  • Hospitalist Physician
  • Saint Louis, MO
  • NPI 1407216336
  Medicare reassignment NPD
• Jewish Family & Children'S Service

  • Community/Behavioral Health Agency
  • Phoenix, AZ
  • NPI 1609939214
  NPD
• Southwest Behavioral Health Services, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Apache Junction, AZ
  • NPI 1932348240
  NPD
• Southwest Behavioral Health Services, Inc.

  • Psychiatric Residential Treatment Facility
  • Kingman, AZ
  • NPI 1023556339
  NPD
• Synovation Integrated Partners, LLC

  • Multi-Specialty Clinic/Center
  • Mesa, AZ
  • NPI 1013565548

  Psychiatric/Mental Health

  NPD
• Mingus Mountain Estate Residencial Center, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Casa Grande, AZ
  • NPI 1891324711
  NPD (past)

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

{
    "created_epoch": "1608249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766880000000",
    "number": "1225624729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21168 E OCOTILLO RD # 1045",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851428175",
            "telephone_number": "623-265-6220",
            "fax_number": "866-491-7389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21168 E OCOTILLO RD # 1045",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851428175",
            "telephone_number": "623-265-6220",
            "fax_number": "866-491-7389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHAVAUN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-18",
        "last_updated": "2025-12-28",
        "certification_date": "2025-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2024022030",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "251493",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.lightattheend.info",
            "affiliation": "N",
            "endpointDescription": "web",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "21168 E Ocotillo Rd # 1045",
            "city": "Queen Creek",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "851428175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joshua James Johnson, MD
• Kade Johnson
• Kevin Johnson, RPH
• Leanne Johnson
• Mark A Johnson, DDS
• Teresa Johnson, MS, LPC
• Nicole Johnston
• Ruby Lee Johnston, MC, LPC, SC, BHP
• Daniel Lester Jones Jr., CPRSS, BHPP
• Desiree Jones

• Psychiatric/Mental Health Nurse Practitioner in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• Psychiatric/Mental Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.