Individual provider Active NPI

Shanikqu Lashun Johnson

  • Prosthetist
  • Cedar Hill, TX
National Provider Identifier
1245840933
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthetistTaxonomy code 224P00000X
Practice address
818 N Highway 67 Ste 102a
Cedar Hill, TX 75104-2150
Phone
(682) 999-7913
NPI assigned
Aug 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case Management 1744P3200X TX
Prosthetist 224P00000X Primary

Addresses

Primary practice location

818 N Highway 67 Ste 102a
Cedar Hill, TX 75104-2150

Mailing address

320 W Pleasant Run Rd Apt 3309
Cedar Hill, TX 75104-0026
Phone (469) 984-5169

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1245840933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 W PLEASANT RUN RD APT 3309",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751040026",
            "telephone_number": "469-984-5169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 N HIGHWAY 67 STE 102A",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751042150",
            "telephone_number": "682-999-7913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHANIKQU",
        "middle_name": "LASHUN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-06",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Hill, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; 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.