MRS. SHANNON ELIZABETH JOHNSON (NPI# 1922178045) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922178045 |
| Entity Type | Individual |
| Full Name | MRS. SHANNON ELIZABETH JOHNSON |
| Credential | PA-C |
| Practice Address |
83 Lewis St Dryden NY 13053 |
| Mailing Address |
4 Ferndale Ln Homer NY 13077-9418 |
| Practice Telephone | 6078448201 |
| Practice Fax Number | 6078444922 |
| Mailing Telephone | 6077496511 |
| Mailing Fax Number | 6078444922 |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
007939-1 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437787579 | Shannon R Johnson | Physical Therapy Assistant | 2030 N 15th Rd, Streator, IL 61364-9754 | 2020-04-01 |
| 1225688146 | Shannon D Johnson | Counselor | 505 University Dr E Ste 501, College Station, TX 77840-1797 | 2019-09-12 |
| 1174184402 | Shannon Symone Johnson | Registered Nurse | 1120 Country View Ln Apt 11d, Toledo, OH 43615-8315 | 2019-06-26 |
| 1114435484 | Shannon Marie Johnson | Nurse Practitioner | 120 Horton Ln, Belvidere, TN 37306-2109 | 2018-01-19 |
| 1972859478 | Shannon Johnson | Counselor | 2502 Beech St Unit 6, Valparaiso, IN 46383-6214 | 2012-08-02 |
| 1295012508 | Shannon Christina Johnson | Physician Assistant | 13111 E. Briarwood Ave #15, Centennial, CO 80112 | 2011-11-15 |
| 1689815771 | Shannon Marie Johnson | Speech-Language Pathologist | 1567 Elmwood Ave, Apt6, Rochester, NY 14620-3616 | 2009-03-18 |
| 1801080619 | Shannon Marie Johnson | Nurse Practitioner | 7900 Highway 76, Pendleton, SC 29670-8876 | 2007-09-05 |
| 1407074719 | Shannon E Johnson | Counselor | 427 Linden, Ave, Memphis, TN 38126 | 2007-04-23 |
| 1902022841 | Shannon Lee Johnson | Counselor | 317 Hospital Street, Moulton, AL 35650 | 2007-04-18 |
| Street Address |
83 LEWIS ST |
| City | DRYDEN |
| State | NY |
| Zip Code | 13053 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164923959 | Lyndsey Jean Sidle | Registered Nurse | 9 Library Street, Dryden, NY 13053 | 2018-02-27 |
| 1770902504 | Cynthia Lane Price | Registered Nurse | 118 Freeville Rd., Dryden, NY 13053 | 2014-04-09 |
| 1033430590 | Dana Michelle Carruth | Acupuncturist | 87 West Main Street, Dryden, NY 13053 | 2010-06-18 |
| 1275769606 | Linda Karen Delong | Registered Nurse | 118 Freeville Rd, Dryden, NY 13053 | 2009-05-29 |
| 1073765954 | Jason R Coburn | Chiropractor | 87 West Main St., Dryden, NY 13053 | 2008-10-22 |
| 1134303258 | Michael Stanley Niziol | Family Medicine | 83 Lewis Street, Dryden, NY 13053 | 2007-12-26 |
| 1548451198 | Alex Andrew Di Matteo | Licensed Practical Nurse | 8 Brookside Dr, Dryden, NY 13053 | 2007-08-08 |
| 1184771602 | Dryden Csd | Local Education Agency (LEA) | 118 Freeville Road, Dryden, NY 13053 | 2007-01-05 |
| 1780785592 | Eckerd Corporation | Durable Medical Equipment & Medical Supplies | 13 15 Main Street, Dryden, NY 13053 | 2006-09-26 |
| 1144230020 | Melita J Mertz | Podiatrist | 52 1/2 North St, Dryden, NY 13053 | 2006-08-09 |
| Find all providers in zip 13053 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487252581 | North Shore Medical Group Pllc | Physician Assistant | 311 Skyview Ter, Syracuse, NY 13219-2835 | 2020-10-12 |
| 1477169654 | Kristen Ariel O'connell | Physician Assistant | 85 John St Apt 7a, New York, NY 10038-2844 | 2020-09-22 |
| 1699381616 | David Nmn Kao | Physician Assistant | 737 Pleasant Avenue, Westbury, NY 11590-6407 | 2020-09-16 |
| 1043824816 | Elizabeth Keane | Physician Assistant | 25 Hollis Dr, Sound Beach, NY 11789-1629 | 2020-08-31 |
| 1497364111 | Tianna Stephens | Physician Assistant | 165 N Village Ave Ste 5, Rockville Centre, NY 11570-3701 | 2020-07-28 |
| 1124636188 | Shannon Maureen O'connell | Physician Assistant | 270-05 270th Ave, New Hyde Park, NY 11040 | 2020-07-16 |
| 1841818895 | Yanick Dugue | Physician Assistant | 4 Lincoln Ave, New Hyde Park, NY 11040-3125 | 2020-07-07 |
| 1194340505 | Kayleigh Marie Tourt | Physician Assistant | 222 Alexander St Fl 4, Rochester, NY 14607-4039 | 2020-06-11 |
| 1023638509 | Kristina Rajic | Physician Assistant | 7237 66th Dr, Flushing, NY 11379-2111 | 2020-04-24 |
| 1114547791 | Michele Hein | Physician Assistant | 700 Veterans Memorial Hwy, Hauppauge, NY 11788-2952 | 2020-04-23 |
| Find all providers with the same taxonomy | ||||
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| 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.