David Shane Johnson (NPI# 1962619932, PAC ID# 9436115292) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1962619932 |
| PAC ID by PECOS | 9436115292 |
| Professional Enrollment ID | I20041203000641 |
| Full Name | David Shane Johnson |
| Organization Legal Name | MAGEE BENEVOLENT ASSOCIATION |
| Address |
360 Simpson Hwy 149 360 Magee MS 39111-3843 |
| Phone Number | 6018491236 |
| Gender | M |
| Credential | PA |
| Graduation Year | 2001 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 3678466463 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 250124 | MAGEE GENERAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 360 Simpson Hwy 149 360, Magee, MS 39111-3843 | 6018491236 | MAGEE BENEVOLENT ASSOCIATION |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Organization Legal Name | MAGEE BENEVOLENT ASSOCIATION |
| Physicians | 7 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| William J Bass | Nurse Practitioner | Magee Benevolent Association | 300 3rd Ave Se, Magee General Hosptial, Magee, MS 39111-3698 |
| Rudolph S Runnels Sr. | General Practice | Magee Benevolent Association | 300 3rd Ave Se Northwing, Sleep Lab, Magee, MS 39111-3665 |
| George E Gillespie Iii | Emergency Medicine | Magee Benevolent Association | 300 3rd Ave Se, Magee General Hosptial, Magee, MS 39111-3698 |
| Walter S Howard | Nurse Practitioner | Magee Benevolent Association | 300 3rd Ave Se, Magee General Hosptial, Magee, MS 39111-3698 |
| Robin Sullivan Hardin | Nurse Practitioner | Magee Benevolent Association | 300 3rd Ave Se, Magee General Hosptial, Magee, MS 39111-3698 |
| Bailey J Ferguson | Diagnostic Radiology | Magee Benevolent Association | 300 3rd Ave Se Northwing, Sleep Lab, Magee, MS 39111-3665 |
| Street Address |
360 SIMPSON HWY 149 360 |
| City | MAGEE |
| State | MS |
| Zip | 39111-3843 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kathleen Patterson Phd | Psychologist, Clinical | 1119 1st Ave Ne, Magee, MS 39111-3111 | |
| Mark A Runnels | Urology | Mississippi Urology Clinic Pllc | 300 3rd St Se, Ms Urology Clinic Pllc, Magee, MS 39111-3665 |
| Maurice O Hinton | Certified Registered Nurse Anesthetist (crna) | Southern Anesthesia Inc | 300 Se 3rd Ave, Magee, MS 39111-3665 |
| Rudolph S Runnels Sr. | General Practice | Magee Benevolent Association | 300 3rd Ave Se Northwing, Sleep Lab, Magee, MS 39111-3665 |
| John B Lyon | Ophthalmology | 300 3rd Ave Se, Magee, MS 39111-3665 | |
| Whitney J Peterson | Physician Assistant | Mississippi Urology Clinic Pllc | 300 3rd St Se, Ms Urology Clinic Pllc, Magee, MS 39111-3665 |
| John D Adams Jr. | Urology | Mississippi Urology Clinic Pllc | 300 3rd St Se, Ms Urology Clinic Pllc, Magee, MS 39111-3665 |
| Allen Mcneil Haraway | Urology | Mississippi Urology Clinic Pllc | 300 3rd St Se, Ms Urology Clinic Pllc, Magee, MS 39111-3665 |
| Harold J Blalock | Urology | Mississippi Urology Clinic Pllc | 300 3rd St Se, Ms Urology Clinic Pllc, Magee, MS 39111-3665 |
| Bailey J Ferguson | Diagnostic Radiology | Magee Benevolent Association | 300 3rd Ave Se Northwing, Sleep Lab, Magee, MS 39111-3665 |
| Find all physicians in zip 39111 | |||
| City | MAGEE |
| Zip Code | 39111 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | MAGEE + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on David Shane 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.