MRS. SHANNON LEE JOHNSON (PA-C) – Physician Assistant, NPI 1750566790
Physician Assistant
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
5,035 PHYSICIAN ASSISTANT in IL
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Provider Addresses for MRS. SHANNON LEE JOHNSON (PA-C)
525, Valley View Drive, Moline, Rock Island County, Illinois, 61265, United States
MOLINE, IL 612656138
Phone: (309) 601-2800
Fax: (309) 601-2801
Type: Mailing
1228 E RUSHOLME ST
MOB 1, SUITE 3020
DAVENPORT, IA 52803
Phone: (563) 421-7540
Fax: (563) 421-7549
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $268.
Total Amount is formed as General ($268) + Research ($0) + Ownership ($0) = $268.
Last reported payment date: 2024-05-22 • Largest payer in this snapshot: Stryker Corporation ($132).
Total Amount
$268
General + Research + Ownership
Payments
5
Total payment records
General Amount
$268
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-05-22
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Stryker Corporation | $132 |
| Inspire Medical Systems, Inc. | $43 |
| Ethicon US, LLC | $38 |
| CONMED Corporation | $35 |
| Avita Medical Americas, Llc | $21 |
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: 2013-03-21
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20130321000621 | I | Physician Assistant | IA | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 19301 | Partial removal of breast | 21 | 21 | $0 |
| 49650 | Repair of groin hernia using an endoscope | 12 | 12 | $0 |
Insurance plans in this area (ZIP 61265)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IA | |
| - | IA | |
| Interventional Cardiology, Cardiovascular Disease (Cardiology) | IA | |
| - | IA | |
| Emergency Medicine, Internal Medicine | IA | |
| - | IA | |
| - | IA | |
| H O S P I T A L I S T | IL | |
| - | NV | |
| - | IA |
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