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SHANNON JOHNSTON
NPI 1902212608
Nurse Practitioner in Indianapolis, IN

Active since July 02, 2014PECOS Enrolled
675 JUSTICE WAY RM C0049, INDIANAPOLIS, IN 46203(877) 465-6650(804) 294-2775 Get Directions Write a Review

NPPES record last updated: July 31, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 19, 2024, Jun 11, 2024 (2 updates tracked since 2024).

About Shannon Johnston NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANNON JOHNSTON (NPI 1902212608) is an individual nurse practitioner in Indianapolis, Indiana, licensed in Indiana (71015147A) and active in the NPI registry since July 2014. She is enrolled in Medicare PECOS and maintains a secondary practice location in Chesterfield.

NPPES Registry Identity

NPI1902212608
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameSHANNON JOHNSTON
Location Address675 JUSTICE WAY RM C0049Indianapolis, IN 46203-1574
Mailing Address12034 Villa Dorado DrSaint Louis, MO 63146-4747 · (314) 692-0703
Phone(877) 465-6650
Fax(804) 294-2775
Sole ProprietorNo
Enumeration DateJuly 2, 2014
Last NPPES UpdateJuly 31, 20252 updates tracked since enumeration
NPPES CertifiedJuly 31, 2025
✔ NPI 1902212608 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
Licenses✔ Licensed in IN · 71015147A✔ Licensed in MO · 2014021871✔ Licensed in IL · 209.012733
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 209.012733 (IL), 2014021871 (MO)
675 JUSTICE WAY RM C0049, Indianapolis, IN 46203
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Secondary Practice Location 1

Location 114477 Callaway CtChesterfield, MO 63017-2303 · Phone (314) 692-0703

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shannon Johnston is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Shannon Johnston reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Mercy Clinic East Communities
244 mi
Family Medicine
615 S NEW BALLAS RD, ADMINISTRATION BUILDING, 5TH FLOOR
Saint Louis, MO 63141
  • Reassigned Medicare billing, Missouri enrollment
  • 744 clinicians in this Medicare group
NPI 1043574940 (314) 251-6000
Holon Health Great Lakes, P.C.
482 mi
Family Medicine
11551 NUCKOLS RD STE R
Glen Allen, VA 23059
  • Reassigned Medicare billing, Arizona, Indiana and Missouri enrollments
  • Medicare enrollment name: Holon Health Great Lakes PC
  • 15 clinicians in this Medicare group
NPI 1194414805 (877) 465-6650

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46203 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. VICTORIA MARIE BLINK LCAC
Counselor (Addiction (Substance Use Disorder))
675 JUSTICE WAY RM C0049
INDIANAPOLIS, IN 46203
Marion County (219) 798-3361

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shannon Johnston's NPI number?

The NPI number for Shannon Johnston is 1902212608. It was assigned to this individual provider in the NPPES registry on July 2, 2014.

Where is Shannon Johnston located?

Shannon Johnston practices at 675 Justice Way Rm C0049, Indianapolis, IN 46203. The listed phone number is (877) 465-6650.

What is Shannon Johnston's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Shannon Johnston enrolled in Medicare?

Yes. Shannon Johnston is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Shannon Johnston's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shannon Johnston reassigns Medicare benefits to 2 organizations: Mercy Clinic East Communities (Saint Louis, MO) and Holon Health Great Lakes, P.C. (Glen Allen, VA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shannon Johnston's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Shannon Johnston accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and Blue Cross Blue Shield of Arizona and 1 other insurer list Shannon Johnston as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shannon Johnston was last updated on July 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.