Shaileen Johnson, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

0996289 Issued in CO

Practice address

1304 N Grand Ave
Pueblo, CO 81003-2718

Phone

(719) 562-2360

NPI assigned

Feb 2, 2021

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Parkview Medical Center, Inc Hospital, Pueblo, CO, CCN 060020

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1225356868
  Medicare reassignment Care Compare group NPD
• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1366763260
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Parkview Medical Center, Inc

  • General Acute Care Hospital
  • Pueblo, CO
  • NPI 1184263527
  Care Compare affiliation
• Parkview Medical Center, Inc

  • General Acute Care Hospital
  • Pueblo, CO
  • NPI 1376183145
  Care Compare affiliation
• Parkview Medical Center, Inc

  • General Acute Care Hospital
  • Pueblo, CO
  • NPI 1417596834
  Care Compare affiliation
• Parkview Medical Center, Inc

  • General Acute Care Hospital
  • Pueblo, CO
  • NPI 1427689652
  Care Compare affiliation
• Parkview Medical Center, Inc.

  • General Acute Care Hospital
  • Pueblo, CO
  • NPI 1104881507
  Care Compare affiliation
• Parkview Medical Center, Inc.

  • General Acute Care Hospital
  • Pueblo, CO
  • NPI 1134751712
  Care Compare affiliation
• Parkview Medical Center, Inc.

  • General Acute Care Hospital
  • Pueblo West, CO
  • NPI 1821720681
  Care Compare affiliation

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

{
    "created_epoch": "1612224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1689265571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 N GRAND AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 N GRAND AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032718",
            "telephone_number": "719-562-2360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "84 S Tequila Dr",
            "address_purpose": "LOCATION",
            "city": "Pueblo West",
            "state": "CO",
            "postal_code": "810072083",
            "country_code": "US",
            "telephone_number": "970-978-1851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHAILEEN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-02",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "0996289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "shaileen_johnson@parkviewmc.com",
            "affiliation": "N",
            "endpointDescription": "professional email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "email",
            "address_1": "1304 N Grand Ave",
            "city": "Pueblo",
            "state": "CO",
            "country_code": "US",
            "postal_code": "810032718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Micah Johnson
• Michael James Johnson, PA
• Patricia Ann Johnson, CMT
• Rebecca Johnson, LPCC, NCC
• Sarah Johnson
• Stephanie M Johnson, NP
• Stephanie Michaela Johnson
• Sussane Johnson
• Tiffani Chantel Johnson
• Abigail Grace Johnston, DPT

• Nurse Practitioner in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; 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.