Shateria Johnson

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Practice address

850 Lake Carolyn Pkwy Apt 3146
Irving, TX 75039-4440

Phone

(469) 864-9931

NPI assigned

Oct 8, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1633651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1649932492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 LAKE CAROLYN PKWY APT 3146",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750394440",
            "telephone_number": "469-864-9931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 LAKE CAROLYN PKWY APT 3146",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750394440",
            "telephone_number": "469-864-9931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHATERIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-08",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "TX",
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leland Jay Johnson
• Melissa Ann Johnson, PNP
• Paige Johnson
• Sara Johnson
• Sharlenta R Johnson, DC
• Shawn L Johnson, OTR/L
• Richard Coleman Johnston, M.D.
• Stephen L Jolissaint, MD
• Danya Jonas, LMT, CIMI
• Jonathan Cargo, O.D., P.a.

• Customized Equipment (DME) in Irving, TX
• Providers in Irving, TX by specialty
• Customized Equipment (DME) in Texas

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