Individual provider Active NPI

Shawn Johnston, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Anchorage, AK
National Provider Identifier
1699746941
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
4332 Issued in AK
Practice address
3801 University Lake Dr
Anchorage, AK 99508-4639
Phone
(907) 563-8876
Fax
(907) 762-6315
NPI assigned
Jan 26, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 4332 AK Primary

Addresses

Primary practice location

3801 University Lake Dr
Anchorage, AK 99508-4639

Mailing address

4100 Lake Otis Pkwy
Ste 216
Anchorage, AK 99508-5230
Phone (907) 563-2873

Other identifiers 1

IdentifierTypeStateIssuer
MD9202MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031120000918 AK Practitioner - Physical Medicine and Rehabilitation 7214841386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of Michigan Medical School, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians
Aa Pain Clinic, Inc.Group PAC ID 7911892443, 6 clinicians

Practice addresses (Care Compare)

10928 Eagle River Rd
Suite 150
Eagle River, AK 99577-8078
Phone (907) 694-8085

4100 Lake Otis Pkwy
Anchorage, AK 99508-5230
Phone (907) 563-2873

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4332AKMDPain Medicine (Physical Medicine & Rehabilitation) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aa Pain Clinic, Inc. CurrentSince Aug 16, 2021 Accepting new patients
Cable & McCormick Apc Past Accepting new patients

Locations

4100 Lake Otis Pkwy
Ste 216
Anchorage, AK 99508
Phone (907) 563-2873

130 S Willow St
Ste 7
Kenai, AK 99611
Phone (907) 283-3752

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14826/brand/1/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1699746941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 LAKE OTIS PKWY",
            "address_2": "STE 216",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085230",
            "telephone_number": "907-563-2873",
            "fax_number": "907-563-5852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 UNIVERSITY LAKE DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084639",
            "telephone_number": "907-563-8876",
            "fax_number": "907-762-6315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "SHAWN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2026-07-13",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "AK",
            "license": "4332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD9202",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.