Individual provider Active NPI

Sharie Johnson

  • Nurse Practitioner
  • Lakeport, CA
National Provider Identifier
1487454450
Registry record updated Aug 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
95036599 Issued in CA
Practice address
987 Parallel Dr Ste C
Lakeport, CA 95453-5708
Phone
(707) 262-5000
NPI assigned
Mar 18, 2025
Last updated
Aug 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN.CNP.0039663 OH
Nurse Practitioner 363L00000X 95036599 CA Primary
Registered Nurse 163W00000X RN.530587 OH

Addresses

Primary practice location

987 Parallel Dr Ste C
Lakeport, CA 95453-5708

Mailing address

5176 Hill Rd E
Lakeport, CA 95453-6300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20251022000618 CA Practitioner - Nurse Practitioner 7113415100 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Ohio State University College of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Bay HospitalsGroup PAC ID 3476506528, 45 clinicians
Sutter Lakeside Home Medical ServicesGroup PAC ID 1850338054, 19 clinicians

Practice addresses (Care Compare)

5176 Hill Rd E
Lakeport, CA 95453-6300
Phone (707) 262-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN.530587OHMDRegistered Nurse
95036599CAMDNurse Practitioner
APRN.CNP.0039663OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Hospitals CurrentSince Oct 3, 2025 Accepting new patients
Sutter Bay Hospitals Current Accepting new patients
Sutter Bay Hospitals CurrentSince Oct 3, 2025 Accepting new patients

Locations

5176 Hill Rd E
Lakeport, CA 95453
Phone (707) 262-5000

5196 Hill Rd E
Ste 300
Lakeport, CA 95453
Phone (707) 263-6885

987 Parallel Dr
Ste C
Lakeport, CA 95453
Phone (707) 262-5000

Organizations & group practices 3

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 1

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": "1742256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754956800000",
    "number": "1487454450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5176 HILL RD E",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954536300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "987 PARALLEL DR STE C",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954535708",
            "telephone_number": "707-262-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-18",
        "last_updated": "2025-08-12",
        "certification_date": "2025-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.0039663",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95036599",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.530587",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeport, CA

Sources for this page

Verify at the official NPI Registry.