Shannon Christina Johnson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

4032 Issued in CO

Practice address

13111 E. Briarwood Ave #15
Centennial, CO 80112

Phone

(303) 632-3640

Fax

(303) 632-3642

NPI assigned

Nov 15, 2011

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

Other names 1

• Shannon Christina Malan Former name

Medicare fee-for-service enrollment

Enrolled in CO

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Geraghty Family Medicine PC

  • Family Medicine Physician
  • Centennial, CO
  • NPI 1285823963
  Medicare reassignment
• Golden Peaks Family Medicine PC

  • Family Medicine Physician
  • Centennial, CO
  • NPI 1710032677
  NPD (past)
• 4C Medical Group PLC

  • Urgent Care Clinic/Center
  • Carefree, AZ
  • NPI 1669916607
  NPD (past)
• Express Urgent Care, PC

  • Urgent Care Clinic/Center
  • Sun City, AZ
  • NPI 1750664231
  NPD (past)

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

{
    "created_epoch": "1321315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511913600000",
    "number": "1295012508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13111 E. BRIARWOOD AVE #105",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "80112",
            "telephone_number": "303-632-3640",
            "fax_number": "303-632-3642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13111 E. BRIARWOOD AVE #15",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "80112",
            "telephone_number": "303-632-3640",
            "fax_number": "303-632-3642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHANNON",
        "middle_name": "CHRISTINA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-15",
        "last_updated": "2017-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "5036",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "4032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "MALAN",
            "middle_name": "CHRISTINA",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Matthew Johnson, LMFT
• Maylene April Johnson, M.A.
• Phillip S Johnson, D.D.S.
• Robert J. Johnson, SAP, MAC, LAC
• Roberta Michelle Johnson, D.C.
• Susan Johnson
• Douglas Leslie Johnston, D.D.S.
• Hannah Johnston
• Sara Johnston, L.AC.
• Joint Venture Chiropractic LLC

• Medical Physician Assistant in Centennial, CO
• Providers in Centennial, CO by specialty
• Medical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2017; 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.