Shannon Marie Johnson, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3331 Issued in SC

Practice address

7900 Highway 76
Pendleton, SC 29670-8876

Phone

(864) 654-1500

NPI assigned

Sep 5, 2007

Last updated

Mar 6, 2020By the provider in NPPES

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 SC

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

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• South Carolina Dept of Mental Health Accounting Office

  dba Patrick B Harris Psychiatric Hospital

  • Psychiatric Hospital
  • Anderson, SC
  • NPI 1376595041
  Medicare reassignment NPD
• South Carolina Dept of Mental Health Accounting Office

  dba Midlands Crisis Stabilization Center

  • Community/Behavioral Health Agency
  • Columbia, SC
  • NPI 1083421994
  NPD

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583452800000",
    "number": "1801080619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 HIGHWAY 252",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296215054",
            "telephone_number": "864-654-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 HIGHWAY 76",
            "city": "PENDLETON",
            "state": "SC",
            "postal_code": "296708876",
            "telephone_number": "864-654-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-05",
        "last_updated": "2020-03-06",
        "certification_date": "2020-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "3331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Healthstat on-Site Clinic/Milliken Pendleton
• Imc of South Carolina
• Innovative Vision Center LLC
• James H. Walker,III Dba Sandy Springs Family Practice
• Laura Quarterman Johnson, PHARMACIST
• Audrey SG Jones, MD
• Janice Marie Kendrick
• Baylee Klindworth
• Christina Koon, MS, RD, CSSD, LRD
• Namour Lamonica, LPC-A

• Family Nurse Practitioner in Pendleton, SC
• Providers in Pendleton, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.