Shearren Johnson

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP143436 Issued in TX

Practice address

4293 Kinsey Dr
Tyler, TX 75703-1004

Phone

(903) 592-5670

Fax

(903) 363-9207

NPI assigned

Oct 10, 2019

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 identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1528600574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 E YOUNG ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756021114",
            "telephone_number": "903-241-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4293 KINSEY DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031004",
            "telephone_number": "903-592-5670",
            "fax_number": "903-363-9207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2162 US Highway 259 S",
            "address_purpose": "LOCATION",
            "city": "Diana",
            "state": "TX",
            "postal_code": "756403510",
            "country_code": "US",
            "telephone_number": "903-663-2055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHEARREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-10",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "TX",
            "license": "AP143436",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP143436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "143436",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://app.medsender.com/",
            "affiliation": "N",
            "endpointDescription": "HIPAA Compliant Messaging",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "PHI",
            "address_1": "4293 Kinsey Dr",
            "city": "Tyler",
            "state": "TX",
            "country_code": "US",
            "postal_code": "757031004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michelle Marie Johnson
• Misty Johnson, PT
• Natalie Inge Johnson, M.D.
• Pegan Danielle Johnson, M.S., CCC-SLP
• Roel Mario Johnson, APT
• Tiffany Johnson
• Tiya Shalyse Johnson, M.D.
• Charles Michael Johnston, PT
• Douglas Frederick Johnston, DO
• Keelie Johnston, PA-C

• Nurse Practitioner in Tyler, TX
• Providers in Tyler, TX by specialty
• Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.