Individual provider Active NPI

Shelby Bowman Johnson, PA-C

  • Medical Physician Assistant
  • Nashville, TN
National Provider Identifier
1457864985
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
3433 Issued in TN
Practice address
3601 The Vanderbilt Clinic
Nashville, TN 37232-1551
Phone
(615) 936-9177
NPI assigned
Nov 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 3433 TN Primary

Addresses

Primary practice location

3601 The Vanderbilt Clinic
Nashville, TN 37232-1551

Mailing address

3841 Green Hills Village Dr
Nashville, TN 37215-2691

Other practice location 1

2410 Patterson St Bsmt Level
Nashville, TN 37203-1551
Phone (615) 342-4850

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sjohnson732823@direct.vumc.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20190126000064 TN Practitioner - Physician Assistant 7719224948 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical University of South Carolina College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vanderbilt University Medical CenterGroup PAC ID 5092023416, 3,510 clinicians

Practice addresses (Care Compare)

3841 Green Hills Dr
Suite 200
Nashville, TN 37215-2691

3841 Green Hills Village Dr
Nashville, TN 37215-2691
Phone (615) 322-8701

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3433TNMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vanderbilt University Medical Center CurrentSince Sep 1, 2022 Accepting new patients
Tennessee Physicians Alliance PC CurrentSince Nov 5, 2018 Accepting new patients
Vanderbilt University Past Accepting new patients
Vanderbilt University PastSince Aug 7, 2022 Accepting new patients

Locations

Dept A T 40379
Atlanta, GA 31192

264 New Shackle Island Rd
Ste 107
Hendersonvlle, TN 37075
Phone (615) 824-4244

5002 Crossings Cir
Mt Juliet, TN 37122
Phone (615) 553-5500

719 Thompson Ln
Nashville, TN 37204
Phone (615) 322-6485

3841 Green Hills Village Dr
Nashville, TN 37215
Phone (615) 322-7127

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GFDCBA
  • Direct secure messaging: sjohnson732823@direct.vumc.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1509926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1457864985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 GREEN HILLS VILLAGE DR",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372152691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 THE VANDERBILT CLINIC",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372321551",
            "telephone_number": "615-936-9177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2410 Patterson St Bsmt Level",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372031551",
            "country_code": "US",
            "telephone_number": "615-342-4850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHELBY",
        "middle_name": "BOWMAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-06",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "3433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjohnson732823@direct.vumc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Service Provider",
            "address_1": "3601 The Vanderbilt Clinic",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372321551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.