Individual provider Active NPI

Shawn Johnson, MSN CNM

  • Advanced Practice Midwife
  • Waconia, MN
National Provider Identifier
1346656089
Registry record updated Jul 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
CNM2103 Issued in MN
Practice address
560 S Maple St
Suite 130
Waconia, MN 55387
Phone
(952) 442-2137
NPI assigned
Jul 2, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X CNM2103 MN Primary

Addresses

Primary practice location

560 S Maple St
Suite 130
Waconia, MN 55387

Mailing address

560 S Maple St
Western OB/GYN; Suite 130
Waconia, MN 55387-1733
Phone (303) 931-1482

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140922000646 MN Practitioner - Certified Nurse Midwife (CNM) 9335368539 Reassigns benefits to 1 organization
I20251122000142 WI Practitioner - Certified Nurse Midwife (CNM) 9335368539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Minnesota Womens Care PAGroup PAC ID 9638329394, 44 clinicians

Practice addresses (Care Compare)

2603 White Bear Ave N
Maplewood, MN 55109-5110
Phone (651) 600-3035

86 Coulee Rd
Suite 201
Hudson, WI 54016-2395
Phone (651) 600-3035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
CNM2103MNMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Healthcare for Women, PA CurrentSince May 1, 2022 Accepting new patients
Minnesota Women'S Care, P.a. CurrentSince May 1, 2022 Accepting new patients
Healtheast Woodwinds Hospital Past Accepting new patients
Healtheast St. John'S Hospital Past Accepting new patients

Locations

15000 Garrett Ave
Apple Valley, MN 55124

2603 White Bear Ave N
Saint Paul, MN 55109
Phone (651) 209-8125

1687 Woodlane Dr
Woodbury, MN 55125
Phone (651) 209-6685

1687 Woodlane Dr
Ste 101
Woodbury, MN 55125
Phone (651) 209-6263

86 Coulee Rd
Ste 201
Hudson, WI 54016
Phone (715) 386-2424

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FAHCDA

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1404259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530748800000",
    "number": "1346656089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 S MAPLE ST",
            "address_2": "WESTERN OB/GYN; SUITE 130",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553871733",
            "telephone_number": "303-931-1482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 S MAPLE ST",
            "address_2": "SUITE 130",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "55387",
            "telephone_number": "952-442-2137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHAWN",
        "name_prefix": "Mrs.",
        "credential": "MSN CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-02",
        "last_updated": "2018-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MN",
            "license": "CNM2103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waconia, MN

Sources for this page

Verify at the official NPI Registry.