ANTALLIA SHAUNTELL JOHNSON (CRNP) – Obstetrics & Gynecology Nurse Practitioner, NPI 1710443767

ANTALLIA SHAUNTELL JOHNSON (CRNP) is a healthcare provider. based in Boaz, Alabama. specializing in NURSE PRACTITIONER. They hold the professional credentials CRNP. They hold a License No. 1-154179 (AL). The NPI Number for ANTALLIA SHAUNTELL JOHNSON (CRNP) is 1710443767

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
ANTALLIA SHAUNTELL JOHNSON (CRNP)
NPI
1710443767
Phone
(256) 840-4530
Address
2505 US HWY 431 WOMEN'S CENTER SUITE A
Enumeration Date
14 February 2019
Last Update Date
14 February 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2058383036
Graduation Year
2018 (8 years ago)
PAC ID
2567704620
Group Practice PAC ID
0244540557
Professional Enrollment ID
I20190422001569
Address ID
AL352353470BI48XXXEXXX501
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:7State licenses:1Digital endpointsOther names

5,653 NURSE PRACTITIONER in AL

Provider Addresses for ANTALLIA SHAUNTELL JOHNSON (CRNP)

  • 2505 US HWY 431 WOMEN'S CENTER SUITE A

    BOAZ, AL 35957

    Phone: (256) 840-4530

    Fax: (256) 840-4537

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 15 Open Payments records for all available years, with a total value of $391.

Total Amount is formed as General ($391) + Research ($0) + Ownership ($0) = $391.

Last reported payment date: 2024-10-23 • Largest payer in this snapshot: Astellas Pharma US Inc ($222).

Total Amount

$391

General + Research + Ownership

Payments

15

Total payment records

General Amount

$391

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-23

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-04-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190422001569INurse PractitionerALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 35957)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0244540557View full group profile
NameSpecialtyState
O B S T E T R I C S/ G Y N E C O L O G YAL
O B S T E T R I C S/ G Y N E C O L O G YAL
O B S T E T R I C S/ G Y N E C O L O G YAL
O B S T E T R I C S/ G Y N E C O L O G YSC
Nurse PractitionerAL
O B S T E T R I C S/ G Y N E C O L O G YAL
O B S T E T R I C S/ G Y N E C O L O G YFL
O B S T E T R I C S/ G Y N E C O L O G YAL
O B S T E T R I C S/ G Y N E C O L O G YAL

Reviews

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Frequently asked questions

Where can patients find ANTALLIA SHAUNTELL JOHNSON (CRNP)'s NPI?
You can confirm ANTALLIA SHAUNTELL JOHNSON (CRNP) with NPI 1710443767; it appears in the national provider directory.
Is ANTALLIA SHAUNTELL JOHNSON (CRNP)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does ANTALLIA SHAUNTELL JOHNSON (CRNP) work in?
You can think of ANTALLIA SHAUNTELL JOHNSON (CRNP) as practicing within Obstetrics & Gynecology Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location metadata exists for ANTALLIA SHAUNTELL JOHNSON (CRNP)?
The page summarizes Boaz, Alabama for ANTALLIA SHAUNTELL JOHNSON (CRNP); expand the address list for detail.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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