Individual provider Active NPI

Shawna Marie Johnston, NNP-BC

  • Neonatal Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1639543135
Registry record updated Nov 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
AP129279 Issued in TX
Practice address
3936 Grizzly Hills Cir
Fort Worth, TX 76244-7482
Phone
(972) 567-7768
NPI assigned
Nov 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X AP129279 TX Primary

Addresses

Primary practice location

3936 Grizzly Hills Cir
Fort Worth, TX 76244-7482

Mailing address

3936 Grizzly Hills Cir
Fort Worth, TX 76244-7482

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20180914001952 TX Practitioner - Nurse Practitioner 5395096291 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
LHP Texas MD Services, Inc CurrentSince Aug 1, 2018 Accepting new patients

Locations

800 W Central Texas Expy
Harker Heights, TX 76548
Phone (254) 618-4933

100 W Central Texas Expy
Ste 210
Killeen, TX 76548

850 W Central Texas Expy
Killeen, TX 76548
Phone (254) 690-0900

Organizations & group practices 1

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": "1447977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447977600000",
    "number": "1639543135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3936 GRIZZLY HILLS CIR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762447482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3936 GRIZZLY HILLS CIR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762447482",
            "telephone_number": "972-567-7768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "SHAWNA",
        "middle_name": "MARIE",
        "credential": "NNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-20",
        "last_updated": "2015-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "TX",
            "license": "AP129279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.