JOHNNA C SHOWN (NPI# 1316398977) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316398977 |
| Entity Type | Individual |
| Full Name | JOHNNA C SHOWN |
| Credential | APRN, FNP-C |
| Practice Address |
120 Executive Park Louisville KY 40207 |
| Mailing Address |
120 Executive Park Louisville KY 40207-4201 |
| Practice Telephone | 5028557200 |
| Practice Fax Number | 5028557201 |
| Mailing Telephone | 5024099925 |
| Mailing Fax Number | 5029199780 |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2019-01-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
3010319 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 300009605 | 05 | |
| AETNA PIN | 6043312 | 01 | |
| ANTHEM PIN | 000001083714 | 01 | |
| KY | 7100465120 | 05 | |
| CARESOURCE ID | CS1811300243 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4001 Dutchmans Ln, Louisville, KY 402074714 | 5028931010 |
| Street Address |
120 EXECUTIVE PARK |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508862202 | Lisa M Schmidt | Nurse Practitioner | 120 Executive Park, Louisville, KY 40207 | 2005-06-27 |
| 1568012896 | Tracey Frederick | Nurse Practitioner | 120 Executive Park, Louisville, KY 40207-4201 | 2019-09-18 |
| 1538672373 | Michele Mcclure | Nurse Practitioner | 120 Executive Park, Louisville, KY 40207-4201 | 2017-11-15 |
| 1467840439 | Mary Tonini | Nurse Practitioner | 120 Executive Park, Louisville, KY 40207-4201 | 2014-12-29 |
| 1306280177 | Commonwealth Pain Associates, Pllc | Anesthesiology | 120 Executive Park, Louisville, KY 40207 | 2013-04-24 |
| 1205187861 | Melanie Dawn Moore | Nurse Practitioner | 120 Executive Park, Louisville, KY 40207-4201 | 2012-09-24 |
| 1366751455 | Nicholas Bryce Mullins | Nurse Practitioner | 120 Executive Park, Louisville, KY 40207-4201 | 2010-10-07 |
| 1780909952 | Jenna Leigh Dismore Wrinkles | Anesthesiology | 120 Executive Park, Louisville, KY 40207-4201 | 2010-03-31 |
| 1679615686 | Stephen Kyle Young | Anesthesiology | 120 Executive Park, Louisville, KY 40207 | 2007-02-13 |
| 1063583268 | James W Jackson Jr. | Anesthesiology | 120 Executive Park, Louisville, KY 40207 | 2006-11-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780212688 | Alexia Louise Bodamer | Student in an Organized Health Care Education/Training Program | 142 Chenoweth Lane, Lousiville, KY 40207 | 2020-03-28 |
| 1467918664 | Amy Rock LLC | Counselor | 4010 Dupont Cir Ste 307, Louisville, KY 40207 | 2019-02-13 |
| 1649745191 | Louisville Optometric Center, IIi, Psc | Optometrist | 285 Hubbards Lane, Suite 300, Louisville, KY 40207 | 2018-10-11 |
| 1184137440 | Crimson Dove Counseling Services Inc | Community/Behavioral Health | 214 Breckenridge Ln., Suite 203, Louisville, KY 40207 | 2017-11-09 |
| 1285157586 | Dickerson Family Enterprise, LLC | Non-emergency Medical Transport (VAN) | 4350 Brownsboro Rd., Ste. 110, Louisville, KY 40207 | 2017-07-19 |
| 1578085296 | Cardiovascular Medical Specialists LLC | Surgery | 100 Mallard Creek Rd Ste 150, Louisville, KY 40207 | 2017-07-14 |
| 1932636305 | Devon Turley | Prevention Professional | 1017 Dupont Rd, Suite 1, Louisville, KY 40207 | 2017-05-17 |
| 1285095539 | Emily Schwartz Crouch | Marriage & Family Therapist | 4010 Dupont Circle, Suite 582, Louisville, KY 40207 | 2016-03-15 |
| 1306201280 | A A and Associates Approved Alcohol/drug Program | Counselor | 4006 Dutchmans Lane, Louisville, KY 40207 | 2015-12-21 |
| 1629433693 | Jewish Hospital and St. Mary's Healthcare, Inc. | General Acute Care Hospital | 3290 Dutchmans Lane, Louisville, KY 40207 | 2015-12-17 |
| Find all providers in zip 40207 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023618535 | Pamela Nicole Kinney | Nurse Practitioner | 13503 Terrace Creek Dr Apt 203, Louisville, KY 40245-5838 | 2020-10-26 |
| 1457950883 | Tetteh Narteh | Nurse Practitioner | 10200 Linn Station Rd Ste 125, Louisville, KY 40223-3889 | 2020-10-16 |
| 1114525540 | Richard A Anane | Nurse Practitioner | 10200 Linn Station Rd Ste 300, Louisville, KY 40223-3841 | 2020-10-16 |
| 1427656081 | Elma Mustic | Nurse Practitioner | 9714 Boxford Way, Louisville, KY 40242-2305 | 2020-10-15 |
| 1679171318 | Cassandra Jane Lee | Nurse Practitioner | 3416 Imperator Ln Unit 103, Louisville, KY 40245-7752 | 2020-10-14 |
| 1942817762 | Merritt Borders | Nurse Practitioner | 1602 Hunnington Pl Apt 4, Louisville, KY 40220-3771 | 2020-09-25 |
| 1114533536 | Lyssa Alexandra Miller | Nurse Practitioner | 5120 Dixie Hwy Ste 101, Louisville, KY 40216-1775 | 2020-09-21 |
| 1174138713 | Paola Cristina Maldonado | Nurse Practitioner | 14719 Eddington Way Apt 304, Louisville, KY 40245-5581 | 2020-09-10 |
| 1033722525 | Bynisha Robertson | Nurse Practitioner | 5312 Sprigwood Ln, Louisville, KY 40291-1135 | 2020-08-25 |
| 1154931202 | Heather M Karem | Nurse Practitioner | 10207 Hartley Dr, Louisville, KY 40223-2735 | 2020-08-04 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40207 |
Please comment or provide details below to improve the information on JOHNNA C SHOWN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.