SHANELL SYLROSE WADE-JOHNSON (APRN) – Family Nurse Practitioner, NPI 1639761620

SHANELL SYLROSE WADE-JOHNSON (APRN) is a healthcare provider. based in Louisville, Kentucky. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN. They hold a License No. 3015778 (KY). The NPI Number for SHANELL SYLROSE WADE-JOHNSON (APRN) is 1639761620

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
SHANELL SYLROSE WADE-JOHNSON (APRN)
NPI
1639761620
Phone
(502) 245-0002
Address
310 E Broadway Ste 100
Enumeration Date
10 February 2021
Last Update Date
5 November 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5022450002
Graduation Year
2020 (6 years ago)
PAC ID
1557769569
Group Practice PAC ID
9931443488
Professional Enrollment ID
I20211005003548
Address ID
KY402021745LO310XXBROA301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

7,347 NURSE PRACTITIONER in KY

Provider Addresses for SHANELL SYLROSE WADE-JOHNSON (APRN)

  • 310 E Broadway Ste 100

    Louisville, KY 402021745

    Phone: (502) 245-0002

    Fax: (502) 742-0485

    Type: Location

  • PO BOX 909

    LOUISVILLE, KY 402010909

    Phone:

    Type: Mailing

  • 530 S JACKSON ST

    LOUISVILLE, KY 402021675

    Phone: (502) 562-4060

    Fax: (502) 457-4035

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2021-10-05

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
I20211005003548INurse PractitionerKYTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
93000Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report160115$0
99213Established patient office or other outpatient visit, 20-29 minutes142105$0
99214Established patient office or other outpatient visit, 30-39 minutes1615$0
View full utilization report →

Insurance plans in this area (ZIP 40202)

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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: 9931443488View full group profile
NameSpecialtyState
Nurse PractitionerKY
Cardiovascular Disease (Cardiology)KY

Reviews

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Frequently asked questions

How do payers reference SHANELL SYLROSE WADE-JOHNSON (APRN)?
For SHANELL SYLROSE WADE-JOHNSON (APRN), use NPI 1639761620 as the unique 10-digit identifier.
Is SHANELL SYLROSE WADE-JOHNSON (APRN) still an active registrant?
SHANELL SYLROSE WADE-JOHNSON (APRN) carries an active NPI according to the public dataset.
How would a patient describe SHANELL SYLROSE WADE-JOHNSON (APRN)'s focus?
For SHANELL SYLROSE WADE-JOHNSON (APRN), the primary taxonomy reads as Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What locale is associated with SHANELL SYLROSE WADE-JOHNSON (APRN)?
Directory geography for SHANELL SYLROSE WADE-JOHNSON (APRN) centers on Louisville, Kentucky.
Does SHANELL SYLROSE WADE-JOHNSON (APRN) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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