Shedra Johnson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C7887 Issued in MS

Practice address

904 Desoto St
Ocean Springs, MS 39564-3737

Phone

(228) 872-8429

Fax

(228) 872-0226

NPI assigned

Jan 12, 2017

Sex

Female

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 MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Applied Psychology Ctr ApcGroup PAC ID 8325039928, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Applied Psychology Ctr Apc

  • Clinical Psychologist
  • Ocean Springs, MS
  • NPI 1457446700
  Medicare reassignment Care Compare group NPD
• Epiphany Counseling Center LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gulfport, MS
  • NPI 1730915778
  NPD Authorized official
• Applied Psychology Center, PC

  • Mental Health Counselor
  • Ocean Springs, MS
  • NPI 1851514277

  Clinical

  NPD (past)

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

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1649716762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 DESOTO ST",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395643737",
            "telephone_number": "228-872-8429",
            "fax_number": "228-872-0226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 DESOTO ST",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395643737",
            "telephone_number": "228-872-8429",
            "fax_number": "228-872-0226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHEDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-12",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "C7887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanna Bosco Counseling Services, LLC
• Brian Johnson
• Francis Johnson III, L.P.T.A
• Kristin Lynnae Johnson, FNP-C
• Robert G Johnson, MD
• Katelyn S Johnston, CRNA
• Garris Nicole Jones, PT
• Hannah Renee Jones
• Kenneth Jones
• Jeremy Scott Jordan, D.C.

• Clinical Social Worker in Ocean Springs, MS
• Providers in Ocean Springs, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; 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.