SHANE JOHNSON – Clinical Social Worker, NPI 1063160620

SHANE JOHNSON is a healthcare provider. based in Staunton, Virginia. specializing in CLINICAL SOCIAL WORKER. They hold a License No. 0904013744 (VA). The NPI Number for SHANE JOHNSON is 1063160620

Main info

Male
14 Years Of Experience
Accepts Medicare Assignment
Name
SHANE JOHNSON
NPI
1063160620
Phone
(540) 213-7566
Address
85 SANGERS LN
Enumeration Date
14 March 2022
Last Update Date
14 March 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5408873200
Graduation Year
2012 (14 years ago)
PAC ID
4284018748
Group Practice PAC ID
3678466398
Professional Enrollment ID
I20230216003086
Address ID
VA244016712ST85XXXLNXX300

Contacts

Other Endpoint
mdoyle@vcsb.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness85
Years active:4State licenses:1Other namesUpdated within 12 months

2,023 CLINICAL SOCIAL WORKER in VA

Provider Addresses for SHANE JOHNSON

  • 85 SANGERS LN

    STAUNTON, VA 244016712

    Phone: (540) 213-7566

    Fax: (540) 887-3245

    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)

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: 2023-02-16

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
I20230216003086IClinical Social WorkerVATBD

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 24401)

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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: 3678466398View full group profile
NameSpecialtyState
P S Y C H I A T R YVA
P S Y C H I A T R YVA
Mental Health CounselorVA
P S Y C H I A T R YVA
-NY
Mental Health CounselorVA
Mental Health CounselorVA
-AL
Mental Health CounselorVA
Mental Health CounselorVA

Reviews

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Frequently asked questions

Does SHANE JOHNSON have a public NPI I can cite?
Public records show SHANE JOHNSON under NPI 1063160620.
Does the public listing show SHANE JOHNSON as active?
SHANE JOHNSON's NPI record reflects an active status in NPPES.
Which specialty label fits SHANE JOHNSON?
NPPES ties SHANE JOHNSON to Clinical Social Worker in the taxonomy section. Clinical services aligned with this taxonomy classification.
Which community is linked to SHANE JOHNSON?
SHANE JOHNSON shows a connection to Staunton, Virginia in registry-derived data.
Why is information missing for SHANE JOHNSON?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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