Individual provider Active NPI

Johnson Shen

  • Psychiatric/Mental Health Nurse Practitioner
  • Houston, TX
National Provider Identifier
1962288894
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1134079 Issued in TX
Practice address
2800 S Macgregor Way
Houston, TX 77021-1032
Phone
(713) 741-5000
NPI assigned
Sep 6, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1134079 TX Primary

Addresses

Primary practice location

2800 S Macgregor Way
Houston, TX 77021-1032

Mailing address

10976 Swang Link Dr
Houston, TX 77043-1437
Phone (832) 533-4360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20231028000000 TX Practitioner - Nurse Practitioner 4385090232 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Progressive Behavioral Health, PLLCGroup PAC ID 4486794906, 366 clinicians

Practice addresses (Care Compare)

23051 Kingwood Place Dr
Suite 110
Kingwood, TX 77339-3962
Phone (844) 824-8775

Merit-based Incentive Payment System (MIPS)

Final score
84.11 of 100Reported as group
Quality
69.15
Promoting interoperability
100
Improvement activities
40
Cost
73.63

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ut Physicians CurrentSince Sep 18, 2023 Accepting new patients
Ut Physicians CurrentSince Sep 18, 2023 Accepting new patients
Progressive Behavioral Health, PLLC Psychiatric/Mental Health CurrentSince Sep 23, 2025 Accepting new patients

Locations

2800 S Macgregor Way
Houston, TX 77021
Phone (713) 741-5000

12505 Memorial Dr
Ste 230
Houston, TX 77024
Phone (210) 858-9078

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

23051 Kingwood Place Dr
Ste 110
Kingwood, TX 77339
Phone (281) 374-4500

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.johnsonshen@136732.advancedmd-direct.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1962288894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10976 SWANG LINK DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770431437",
            "telephone_number": "832-533-4360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 S MACGREGOR WAY",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770211032",
            "telephone_number": "713-741-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEN",
        "first_name": "JOHNSON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-06",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1134079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.