NPIMap

Individual provider Active NPI

Shae Ashley Johnston

  • Medical Physician Assistant
  • Kannapolis, NC
National Provider Identifier
1730075144
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
001015594 Issued in NC
Practice address
4949 Professional Park Dr Ste 101
Kannapolis, NC 28081-8638
Phone
(704) 938-6521
NPI assigned
Jun 13, 2025
Last updated
Oct 14, 2025By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 001015594 NC Primary

Addresses

Primary practice location

4949 Professional Park Dr Ste 101
Kannapolis, NC 28081-8638

Mailing address

1750 Camden Rd Apt 319
Charlotte, NC 28203-6553
Phone (912) 506-1451

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260105003133 NC Practitioner - Physician Assistant 3375039878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

4949 Professional Park Dr
Suite 101
Kannapolis, NC 28081-8638
Phone (704) 938-6521

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
001015594NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Oct 3, 2025 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Oct 3, 2025 Accepting new patients

Locations

270 Copperfield Blvd NE
Ste 102
Concord, NC 28025
Phone (704) 721-2060

4949 Professional Park Dr
Ste 101
Kannapolis, NC 28081
Phone (704) 938-6521

Interoperability endpoints

  • Direct secure messaging: sjohnston3034351@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 3

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.

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1749772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1730075144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 CAMDEN RD APT 319",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282036553",
            "telephone_number": "912-506-1451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4949 PROFESSIONAL PARK DR STE 101",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280818638",
            "telephone_number": "704-938-6521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "SHAE",
        "middle_name": "ASHLEY",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-06-13",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "001015594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kannapolis, NC

Sources for this page

Verify at the official NPI Registry.