JOHNNY SHANE ROSS (M.D.) – Physical Medicine & Rehabilitation Physician, NPI 1104935030

JOHNNY SHANE ROSS (M.D.) is a healthcare provider. based in Lakeway, Texas. specializing in PHYSICAL MEDICINE AND REHABILITATION. They hold the professional credentials M.D.. They hold a License No. J6036 (TX). The NPI Number for JOHNNY SHANE ROSS (M.D.) is 1104935030

Main info

Male
33 Years Of Experience
Accepts Medicare Assignment
Name
JOHNNY SHANE ROSS (M.D.)
NPI
1104935030
Phone
(512) 263-4511
Address
2000 MEDICAL DR
Enumeration Date
30 August 2006
Last Update Date
23 October 2024

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS MEDICAL SCHOOL AT HOUSTON
Secondary Phone
-
Graduation Year
1993 (33 years ago)
PAC ID
5193710143
Professional Enrollment ID
I20141007002261
Address ID
TX765080001TE2401XSTXX400

Contacts

Secure Messaging
jross1352854@direct.sw.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

863 PHYSICAL MEDICINE AND REHABILITATION in TX

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Provider Addresses for JOHNNY SHANE ROSS (M.D.)

  • Lakeway Urgent Care, Medical Park Drive, Lenoir City, Loudon County, East Tennessee, Tennessee, 37771, United States

    LAKEWAY, TX 787344200

    Phone: (512) 263-4511

    Fax: (512) 263-4506

    Type: Location

  • 2101, Headwater Lane, Austin, Travis County, Texas, 78746, United States

    AUSTIN, TX 787467858

    Phone: (580) 585-0180

    Type: Mailing

  • 2401 S 31ST ST BLDG 35

    TEMPLE, TX 765084200

    Phone: (254) 724-2111

    Fax: (512) 263-4506

    Type: Location

  • PO BOX 844658

    DALLAS, TX 752844658

    Phone:

    Type: Mailing

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: 2014-10-07

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
I20141007002261IPhysical Medicine And RehabilitationTXTBD

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
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes6,373198$0
J3480Injection, potassium chloride, per 2 meq2,136170$0
96375Injection of additional new drug or substance into vein1,918166$0
97016Application of blood vessel compression device1,667197$0
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care1,647197$0
View full utilization report →

Insurance plans in this area (ZIP 78734)

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Reviews

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Frequently asked questions

What NPI should I save for JOHNNY SHANE ROSS (M.D.)?
Save NPI 1104935030 if you need a stable reference for JOHNNY SHANE ROSS (M.D.).
Does this profile mean JOHNNY SHANE ROSS (M.D.) is currently active?
Yes — JOHNNY SHANE ROSS (M.D.) appears active in the national provider directory.
Can you summarize JOHNNY SHANE ROSS (M.D.)'s specialty in plain language?
Clinically, the directory lists JOHNNY SHANE ROSS (M.D.) with Physical Medicine & Rehabilitation Physician. Clinical services aligned with this taxonomy classification.
What location shows for JOHNNY SHANE ROSS (M.D.)?
We surface Lakeway, Texas for JOHNNY SHANE ROSS (M.D.) based on available NPPES addresses.
How can I contact JOHNNY SHANE ROSS (M.D.)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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