Active NPI
Shaun Johnson
- Student in an Organized Health Care Education/Training Program
- Ypsilanti, MI
National Provider Identifier
1821858416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 5333 McAuley Drive
Suite 4001
Ypsilanti, MI 48197-8633 - Phone
- (734) 712-3980
- NPI assigned
- Mar 20, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
5333 McAuley Drive
Suite 4001
Ypsilanti, MI 48197-8633
Mailing address
11619 Rodeo Dr
Burnsville, MN 55337-1290
Phone (952) 567-4899
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710892800000",
"number": "1821858416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11619 RODEO DR",
"city": "BURNSVILLE",
"state": "MN",
"postal_code": "553371290",
"telephone_number": "952-567-4899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5333 MCAULEY DRIVE",
"address_2": "SUITE 4001",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481978633",
"telephone_number": "734-712-3980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "SHAUN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-03-20",
"last_updated": "2024-03-20",
"certification_date": "2024-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ypsilanti, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; 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.