Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Johnnjalyn Shataun Manning, APRN-BC

Individual provider Family Nurse Practitioner · NPI 1104714278

Johnnjalyn Shataun Manning, APRN-BC is a Nurse Practitioner in Fort Worth, Texas. Qualified in 2025, 1 year ago. Practices with Acclaim Physician Group Inc, a 523-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
1
Licensed in
TX
In the registry since
2025
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Practice location Address checks out

1500 S Main St
Fort Worth, TX 76104-4917
Phone: (817) 702-1100
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 1210013 (TX)

Record details

NPI number1104714278
Entity typeIndividual (Type 1)
GenderFemale
Credentials APRN-BC
Sole proprietorNo
NPI enumeratedJune 26, 2025
Last updated in NPPESAugust 25, 2025
Certification dateAugust 25, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Acclaim Physician Group Inc — 523 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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