SHANNON A. JOHNSON M.D., PA (NPI# 1609103456) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609103456 |
| Entity Type | Organization |
| Organization Name | SHANNON A. JOHNSON M.D., PA |
| Practice Address |
3901 Airport Fwy Suite 320 Bedford TX 76021-6117 |
| Mailing Address |
Po Box 1250 Rowlett TX 75030-1250 |
| Practice Telephone | 8172837400 |
| Practice Fax Number | 8172837406 |
| Mailing Telephone | 8172837400 |
| Mailing Fax Number | 8172837406 |
| Enumeration Date | 2009-11-14 |
| Last Update Date | 2010-02-01 |
| Authorized Official Name | DR. SHANNON ANDREA JOHNSON (PRESIDENT) |
| Authorized Official Telephone | 8172837400 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
K7174 | TX | Ambulatory Health Care Facilities |
| Street Address |
3901 AIRPORT FWY SUITE 320 |
| City | BEDFORD |
| State | TX |
| Zip Code | 76021-6117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326146960 | Shannon Johnson | Psychiatry & Neurology | 3901 Airport Fwy, Suite 320, Bedford, TX 76021-6117 | 2006-09-20 |
| 1962931329 | Zurisadai Benitez | Counselor | 3901 Airport Fwy, #230, Bedford, TX 76021 | 2017-06-08 |
| 1558896936 | Tori Dixon | Counselor | 3901 Airport Fwy, 107, Bedford, TX 76021-6117 | 2017-04-24 |
| 1922476597 | Katharine Ottone | Counselor | 3901 Airport Fwy, 230, Bedford, TX 76021-6117 | 2015-09-12 |
| 1366834558 | Texas Premier Ob/gyn Center, Pllc | Specialist | 3901 Airport Fwy, Suite 230, Bedford, TX 76021-6117 | 2015-02-24 |
| 1235477829 | Zachary Thomas Zender | Counselor | 3901 Airport Fwy, Suite 230, Bedford, TX 76021-6117 | 2013-01-16 |
| 1902178718 | Cathy M Tran | Chiropractor | 3901 Airport Fwy, Suite 115, Bedford, TX 76021-6117 | 2012-02-08 |
| 1417254319 | Dawn Michelle Anzualda | Counselor | 3901 Airport Fwy, Suite 230, Bedford, TX 76021-6117 | 2011-02-12 |
| 1881813954 | Shifacare Inc. | Home Health | 3901 Airport Fwy, Suite 105, Bedford, TX 76021-6117 | 2007-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396357851 | Crystal Le | Pharmacist | 4121 E Hardwood Rd, Bedford, TX 76021 | 2020-08-17 |
| 1114544095 | Morgan Sanders | Physical Therapist | 2419 Tx 121, Bedford, TX 76021 | 2020-06-26 |
| 1669938171 | Tracie Thomas | Nurse Practitioner | 3901 Airport Freeway, Suite 230, Bedford, TX 76021 | 2019-02-20 |
| 1346710928 | Bedford Pharmacy LLC | Pharmacy | 2816 Central Dr Ste 160, Bedford, TX 76021 | 2018-11-27 |
| 1861973562 | Healogix Consultants, LLC | Pharmacy | 601-1 Harwood Rd, Bedford, TX 76021 | 2018-08-22 |
| 1851870570 | Artie Lee Nolen | Licensed Vocational Nurse | 1415 Shady Ln, Bedford, TX 76021 | 2018-08-13 |
| 1821510496 | Gabriela D Driskill | Counselor | 201 E. 9th Street, Dallas, TX 76021 | 2017-07-14 |
| 1588190938 | Tdc-bedford Dialysis Clinic LLC | Clinic/Center | 725 N Industrial Blvd, Ste 100, Bedford, TX 76021 | 2017-05-04 |
| 1801246673 | Tamara Allen-wolf, LLC | Counselor | 2217 Martin Dr., Ste 200, Bedford, TX 76021 | 2016-06-13 |
| 1013399799 | Nirvana Dental | Clinic/Center | 3704 Cheek Sparger Road #100, Bedford, TX 76021 | 2015-06-18 |
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| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144757691 | Dawn Wyman Licsw Pllc | Clinic/Center | 3 Executive Park Dr Ste 212, Bedford, NH 03110-6975 | 2017-05-15 |
| 1376813147 | Hoosier Uplands Economic Development Corporation | Clinic/Center | 2125 16th St, Bedford, IN 47421-3003 | 2012-01-10 |
| 1154452779 | La Mora Psychological Associates, P.a. | Clinic/Center | 82 Palomino Ln, Suite 702, Bedford, NH 03110-6448 | 2007-03-07 |
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| 1376169268 | Bolin Counseling Services Pllc | Clinic/Center | 555 Round Rock West Dr Ste E222, Round Rock, TX 78681-5052 | 2020-06-17 |
| 1376168682 | Edge of Town Productions, LLC | Clinic/Center | 746 Dayridge Dr, Dripping Springs, TX 78620-2128 | 2020-06-11 |
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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.