Active NPI
Shauna R Johnson, FNP-BC, PMHNP-BC
- Family Nurse Practitioner
- Greenville, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 18232
- Practice address
- 10 Patewood Dr Ste 130
Greenville, SC 29615-6317 - Phone
- (864) 455-8988
- Fax
- (864) 455-4540
- NPI assigned
- Aug 11, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | ARNP9455780 | FL | |
| Family Nurse Practitioner | 363LF0000X | ARNP9455780 | FL | |
| Family Nurse Practitioner | 363LF0000X | 18232 | SC | Primary |
Addresses
Primary practice location
10 Patewood Dr Ste 130
Greenville, SC 29615-6317
Mailing address
300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603
Other practice location 1
1405 Clifton Rd NE
Atlanta, GA 30322-1060
Phone (404) 785-6000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760596480 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP9455780 | FL | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prisma Health University Medical Group | Current | Accepting new patients | |
| Prisma Health University Medical Group | Current | Accepting new patients |
Locations
210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123
300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615
10 Patewood Dr
Ste 130
Greenville, SC 29615
Phone (864) 455-8988
Interoperability endpoints
- sjohnson591729@direct.ghs.myhfn.org
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 and National Provider Directory roles.
-
- Family Medicine Physician
- Greenville, SC
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-
- Gynecology Physician
- Greer, SC
- NPI 1003619313
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1249948800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707091200000",
"number": "1902038821",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 E MCBEE AVE FL 4",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296012842",
"telephone_number": "864-522-8603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 PATEWOOD DR STE 130",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296156317",
"telephone_number": "864-455-8988",
"fax_number": "864-455-4540"
}
],
"practiceLocations": [
{
"address_1": "1405 Clifton Rd NE",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303221060",
"country_code": "US",
"telephone_number": "404-785-6000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "SHAUNA",
"middle_name": "R",
"credential": "FNP-BC, PMHNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-08-11",
"last_updated": "2024-02-05",
"certification_date": "2024-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "FL",
"license": "ARNP9455780",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "FL",
"license": "ARNP9455780",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "SC",
"license": "18232",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1760596480",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.