Shelby Lynn Johnson

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA16259 Issued in TX

Practice address

1411 N Beckley Ave Ste 363
Dallas, TX 75203-1558

Phone

(214) 438-5188

NPI assigned

Nov 29, 2022

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

Electronic endpoints 1

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1669680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1902516099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 N BECKLEY AVE STE 363",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752031558",
            "telephone_number": "214-438-5188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 N BECKLEY AVE STE 363",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752031558",
            "telephone_number": "214-438-5188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHELBY",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-29",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA16259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shelby@dallasent.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1411 N Beckley Ave Ste 363",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752031558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sean Daniel Johnson, M.D.
• Shaheedra Aveonne Johnson, M.S., LPC
• Shakira A. Johnson, PA-C
• Shatona Vanetta Johnson
• Sheena Johnson, PMHNP
• Shiny Mary Johnson, PHARM-D
• Stacie N Johnson, MD
• Steven T Johnson, MA, MABS, LPC
• Tamara Nolita Johnson, MSSW
• Tammie Kay Johnson, OTR

• Medical Physician Assistant in Dallas, TX
• Providers in Dallas, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; 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.