Shane Johnson, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

01092392A Issued in IN

Practice address

2001 W 86TH St
Indianapolis, IN 46260-1902

Phone

(317) 338-2345

Fax

(317) 338-6359

NPI assigned

Apr 5, 2019

Sex

Male

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

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Anesthesiology

Education

Washington University School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Vincent Heart Center Hospital, Carmel, IN, CCN 150153
• Ascension St Vincent Hospital Hospital, Indianapolis, IN, CCN 150084

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• St. Vincent Medical Group, Inc.

  dba Ascension Medical Group St. Vincent

  • Orthopaedic Surgery Physician
  • Winchester, IN
  • NPI 1144513375

  Anesthesiology

  Medicare reassignment Care Compare group NPD
• St. Vincent Medical Group, Inc.

  dba Ascension Medical Group St. Vincent

  • Internal Medicine Physician
  • Carmel, IN
  • NPI 1811881527
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Vincent Heart Center of Indiana, LLC

  dba Ascension St. Vincent Heart Center

  • Special Hospital
  • Carmel, IN
  • NPI 1982681748
  Care Compare affiliation
• St. Vincent Hospital & Health Care Center, Inc.

  dba Ascension St. Vincent Hospital

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1306898960
  Care Compare affiliation
• St. Vincent Hospital & Health Care Center, Inc.

  dba Ascension St. Vincent - Avon

  • General Acute Care Hospital
  • Avon, IN
  • NPI 1851833230
  Care Compare affiliation

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

{
    "created_epoch": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1356803431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 W 86TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W 86TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601902",
            "telephone_number": "317-338-2345",
            "fax_number": "317-338-6359"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10580 N Meridian St",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "IN",
            "postal_code": "46290",
            "country_code": "US",
            "telephone_number": "317-583-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-05",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01092392A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Dee Johnson, M.D.
• Sarah Elizabeth Johnson
• Sarah K. Johnson, DPT
• Sarah Kathleen Johnson, BSN, RN
• Sean Christopher Johnson
• Shannon Laela Johnson
• Shante Johnson
• Shelley Johnson
• Shurell R Johnson, MSW, LSW
• Shyana Dannielle Johnson

• Anesthesiology Physician in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Anesthesiology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.