MR. DAVID SHANE JOHNSON (NPI# 1962619932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962619932 |
| Entity Type | Individual |
| Full Name | MR. DAVID SHANE JOHNSON |
| Credential | PA-C |
| Practice Address |
376a Simpson Highway 149 Magee MS 39111-3409 |
| Mailing Address |
Po Box 769 Magee MS 39111-0769 |
| Practice Telephone | 6018491475 |
| Practice Fax Number | 6018491549 |
| Mailing Telephone | 6018491475 |
| Mailing Fax Number | 6018491549 |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2019-12-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA024 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00125918 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841804044 | David Johnson | Home Health Aide | 4436 Davis Grove Blvd, Olive Branch, MS 38654-5631 | 2020-09-04 |
| 1952803314 | David M Johnson | Specialist | 1345 Nw 15th St, Lincoln City, OR 97367-3327 | 2018-03-01 |
| 1932615333 | David Johnson | Hearing Instrument Specialist | 905 N Cass St, Wabash, IN 46992-1043 | 2017-12-20 |
| 1316457211 | David Johnson | Specialist/Technologist | 14354 Mission Way, Broomfield, CO 80023-4049 | 2017-10-05 |
| 1437519501 | David Hale Johnson | Nurse Practitioner | 169 Doctors Drive, Boone, NC 28607 | 2016-03-02 |
| 1366812141 | David Clayton Johnson | Occupational Therapist | 201 Ridgecrest Dr, Chapel Hill, NC 27514-2104 | 2015-10-06 |
| 1447635529 | David Johnson | Student in an Organized Health Care Education/Training Program | 9666 Kent St, Elk Grove, CA 95624 | 2015-07-30 |
| 1245623628 | David Johnson | Pharmacist | 10223 50th Ave E, Tacoma, WA 98446-5412 | 2015-03-10 |
| 1710377585 | David Jackson Johnson | Counselor | 862 S Main St Ste 2, Brigham City, UT 84302-3300 | 2015-01-30 |
| 1376892828 | David Berek Johnson | Chiropractor | 7559 Kayne Blvd, Columbus, GA 31909-2521 | 2012-08-30 |
| Street Address |
376A SIMPSON HIGHWAY 149 |
| City | MAGEE |
| State | MS |
| Zip Code | 39111-3409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629177712 | Dm and C | Family Medicine | 376a Simpson Highway 149, Magee, MS 39111-3409 | 2006-09-22 |
| 1336477215 | Magee Benevolent Association | General Acute Care Hospital | 376a Simpson Highway 149, Magee, MS 39111-3409 | 2009-12-03 |
| 1487819934 | Magee Benevolent Association D/b/a Magee General Hospital | Physician Assistant | 376a Simpson Highway 149, Magee, MS 39111-3409 | 2008-07-24 |
| 1528167608 | Wbd | Family Medicine | 376a Simpson Highway 149, Magee, MS 39111-3409 | 2006-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235669136 | Maxem Health Urgent Care Magee | Clinic/Center | 1529 Highway 49 S, Suite A, Magee, MS 39111 | 2017-06-14 |
| 1427409200 | Ashley Bounds | Specialist/Technologist | 499 Pinewood Dr., Magee, MS 39111 | 2016-06-23 |
| 1053707083 | Dental Group of Magee Pllc | Dentist | 1667 Highway 49s Ste 6, Magee, MS 39111 | 2015-04-07 |
| 1528387859 | Brandi's Hope Community Services | In Home Supportive Care | 720b 3rd Ave Sw, Magee, MS 39111 | 2010-05-26 |
| 1801128129 | Family Dental Care | Dentist | 203 Main Ave N, Magee, MS 39111 | 2010-02-11 |
| 1033342688 | Family Health Care Clinic, Inc. | Clinic/Center | 820 Johnson Lockhart Drive North East, Magee, MS 39111 | 2009-08-31 |
| 1043403124 | Charlene William Jones-smith | Speech-Language Pathologist | 193 Colonial Circle, Magee, MS 39111 | 2007-08-22 |
| 1326254301 | Envision Eye Care, Inc | Optometrist | 1625 Simpson Hwy 49, Magee, MS 39111 | 2007-05-15 |
| 1487878054 | Jack R Magee Jr. | Dentist | 1425 Simpson Highway 49, Magee, MS 39111 | 2007-04-12 |
| 1104945096 | Magee Benevolent Association | Pediatrics | 310 2nd Se St, Magee, MS 39111 | 2007-03-29 |
| Find all providers in zip 39111 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902013584 | Magee After Hours Clinic Pllc | Physician Assistant | 376 Simpson Highway 149 # A, Magee, MS 39111-3409 | 2007-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831703958 | Melanie Layne Mccoy | Physician Assistant | 202 Joyce Ave, Long Beach, MS 39560-4332 | 2020-09-04 |
| 1437785482 | Kimberly Jordan Tupper | Physician Assistant | 6371 Shenandoah Ln, Olive Branch, MS 38654-3425 | 2020-03-20 |
| 1700419041 | Alexander Sorokin Flecker | Physician Assistant | 200b Eager St, Clinton, MS 39056-4545 | 2020-02-14 |
| 1548892904 | Meghan Seymour | Physician Assistant | 510 Glensview Dr, Brandon, MS 39047-7919 | 2020-02-04 |
| 1982234183 | Eva Mackenzie Carmody | Physician Assistant | 1190 N State St Suite 502, Jackson, MS 39202 | 2020-01-16 |
| 1477190668 | Kimberly Mcraney Watson | Physician Assistant | 907 Oakhill Cir, Clinton, MS 39056-3743 | 2019-12-06 |
| 1598301632 | Daniel Edward Bloom | Physician Assistant | Naval Branch Health Clinic Gulfport, 5502 Marvin Shields Blvd, Gulfport, MS 39501 | 2019-11-25 |
| 1467097956 | Chandler Stengel | Physician Assistant | 7900 Airways Blvd., Ste B102, Southaven, MS 38671-5809 | 2019-11-08 |
| 1922653526 | Lauren Ramsey | Physician Assistant | 845 E Scenic Dr, Pass Christian, MS 39571-4624 | 2019-08-09 |
| 1972161891 | Allison Taylor | Physician Assistant | 1850 Chadwick Drive, Suite 1427, North Tower, 4 West, Jackson, MS 39204-3404 | 2019-06-05 |
| 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.