Matthew Shanon Johnson (NPI# 1659711455, PAC ID# 3072817824) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is EMERGENCY MEDICINE.
| Nation Provider ID (NPI) | 1659711455 |
| PAC ID by PECOS | 3072817824 |
| Professional Enrollment ID | I20160215002258 |
| Full Name | Matthew Shanon Johnson |
| Organization Legal Name | MACCORKLE EMERGENCY PHYSICIANS PLLC |
| Address |
4605 Maccorkle Ave Sw South Charleston WV 25309-1311 |
| Phone Number | 3047663601 |
| Gender | M |
| Graduation Year | 2013 |
| Primary Specialty | EMERGENCY MEDICINE |
| Secondary Specialties | FAMILY MEDICINE |
| Group Practice PAC ID | 8426394875 |
| Number of Group Practice Members | 21 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 010055 | FLOWERS HOSPITAL |
| 510029 | THOMAS MEMORIAL HOSPITAL |
| 010078 | NORTHEAST ALABAMA REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 400 E 10th St, Anniston, AL 36207-4716 | 2562355121 | APP OF ALABAMA ED PLLC |
| 15155 Hwy 43, Russellville, AL 35653-1975 | 2563321611 | APP OF ALABAMA ED PLLC |
| 4605 Maccorkle Ave Sw, South Charleston, WV 25309-1311 | 3047663601 | MACCORKLE EMERGENCY PHYSICIANS PLLC |
| Organization Legal Name | MACCORKLE EMERGENCY PHYSICIANS PLLC |
| Physicians | 12 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert H Romaine | Emergency Medicine | Maccorkle Emergency Physicians Pllc | 4605 Maccorkle Ave Sw, South Charleston, WV 25309-1311 |
| Ryan B Natale | Emergency Medicine | Maccorkle Emergency Physicians Pllc | 4605 Maccorkle Ave Sw, South Charleston, WV 25309-1311 |
| Chadwick R Smith | Emergency Medicine | Maccorkle Emergency Physicians Pllc | 4605 Maccorkle Ave Sw, South Charleston, WV 25309-1311 |
| Robert B Chrest | Emergency Medicine | Maccorkle Emergency Physicians Pllc | 4605 Maccorkle Ave Sw, South Charleston, WV 25309-1311 |
| Benjamin W De Witt | Emergency Medicine | Maccorkle Emergency Physicians Pllc | 4605 Maccorkle Ave Sw, South Charleston, WV 25309-1311 |
| Vonda K Kiser-thomasson | Nurse Practitioner | Maccorkle Emergency Physicians Pllc | 4605 Maccorkle Ave Sw, South Charleston, WV 25309-1311 |
| Alexis Marco Rodriguez | Emergency Medicine | Maccorkle Emergency Physicians Pllc | 4605 Maccorkle Ave Sw, South Charleston, WV 25309-1311 |
| Suhiab Ased | Emergency Medicine | Maccorkle Emergency Physicians Pllc | 4605 Maccorkle Ave Sw, South Charleston, WV 25309-1311 |
| Matthew Wayne Williamson | Nurse Practitioner | Maccorkle Emergency Physicians Pllc | 4605 Maccorkle Ave Sw, South Charleston, WV 25309-1311 |
| Michael S Johnson | Emergency Medicine | Maccorkle Emergency Physicians Pllc | 4605 Maccorkle Ave Sw, South Charleston, WV 25309-1311 |
| Street Address |
4605 MACCORKLE AVE SW |
| City | SOUTH CHARLESTON |
| State | WV |
| Zip | 25309-1311 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Laura D Moon | Certified Registered Nurse Anesthetist (crna) | Professional Anesthesia Service,inc. | 4605 Maccorkle Ave Sw, Thomas Memorial Hospital, South Charleston, WV 25309-1398 |
| Robert H Romaine | Emergency Medicine | Maccorkle Emergency Physicians Pllc | 4605 Maccorkle Ave Sw, South Charleston, WV 25309-1311 |
| Pamela Kay Maddox | Nurse Practitioner | Ths Physician Partners Inc | 4605 Maccorkle Ave Sw, South Charleston, WV 25309-1311 |
| Tammy L Cunningham | Certified Registered Nurse Anesthetist (crna) | Professional Anesthesia Service,inc. | 4605 Maccorkle Ave Sw, Thomas Memorial Hospital, South Charleston, WV 25309-1398 |
| Jennifer L Byus | Certified Registered Nurse Anesthetist (crna) | Professional Anesthesia Service,inc. | 4605 Maccorkle Ave Sw, Thomas Memorial Hospital, South Charleston, WV 25309-1398 |
| Jimi L Baisden | Certified Registered Nurse Anesthetist (crna) | Professional Anesthesia Service,inc. | 4605 Maccorkle Ave Sw, Thomas Memorial Hospital, South Charleston, WV 25309-1398 |
| Jessica Dawn Weese | Certified Registered Nurse Anesthetist (crna) | Professional Anesthesia Service,inc. | 4605 Maccorkle Ave Sw, Thomas Memorial Hospital, South Charleston, WV 25309-1398 |
| Victoria L Mullins | Physician Assistant | Ths Physician Partners Inc | 4605 Maccorkle Ave Sw, South Charleston, WV 25309-1311 |
| Melissa Dawn Price | Certified Registered Nurse Anesthetist (crna) | Professional Anesthesia Service,inc. | 4605 Maccorkle Ave Sw, Thomas Memorial Hospital, South Charleston, WV 25309-1398 |
| Bethany Dawn Hoylman | Nurse Practitioner | Ths Physician Partners Inc | 4605 Maccorkle Ave Sw, South Charleston, WV 25309-1311 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jeremy Dale Walker | Nurse Practitioner | Ths Physician Partners Inc | 506 Chestnut St, South Charleston, WV 25309-1204 |
| Michael S Dewitt | Family Medicine | Ths Physician Partners Inc | 506 Chestnut St, South Charleston, WV 25309-1204 |
| Amy Marie Combs | Physician Assistant | Ths Physician Partners Inc | 506 Chestnut St, South Charleston, WV 25309-1204 |
| Gregory Thomas Lagos | Dermatology | Center for Dermatology and Skin Care, Inc. | 607 Chestnut St, South Charleston, WV 25309-1205 |
| Megan C Evans | Physician Assistant | Center for Dermatology and Skin Care, Inc. | 607 Chestnut St, South Charleston, WV 25309-1205 |
| Derek L. Ramsey | Physician Assistant | Center for Dermatology and Skin Care, Inc. | 607 Chestnut St, South Charleston, WV 25309-1205 |
| Randi Linn Dillon | Physician Assistant | Center for Dermatology and Skin Care, Inc. | 607 Chestnut St, South Charleston, WV 25309-1205 |
| Jacqueline Moore | Physician Assistant | South Charleston Dermatology Pllc | 4815 Kanawha Ave Sw, South Charleston, WV 25309-1207 |
| Michelle Leigh Endicott | Dermatology | South Charleston Dermatology Pllc | 4815 Kanawha Ave Sw, South Charleston, WV 25309-1207 |
| Todd V Kreitzer | Dermatology | South Charleston Dermatology Pllc | 4815 Kanawha Ave Sw, South Charleston, WV 25309-1207 |
| Find all physicians in zip 25309 | |||
| City | SOUTH CHARLESTON |
| Zip Code | 25309 |
| Specialty | EMERGENCY MEDICINE |
| City + Specialty | SOUTH CHARLESTON + EMERGENCY MEDICINE |
Please comment or provide details below to improve the information on Matthew Shanon Johnson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.