Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Shannon Patrick Johnson, IDC

Individual provider Independent Duty Corpsman · NPI 1164635520

Mr. Shannon Patrick Johnson, IDC is an Independent Duty Corpsman in Norfolk, Virginia. Registered with an NPI since 2007.

In the registry since
2007

Practice location Address may be wrong

The ZIP code does not match the city and state on this record. Call before visiting.

1004 Hermitage Rd Bldg 2052
Norfolk, VA 23521-5000
Phone: (757) 462-3178

Specialties & licences

Independent Duty Corpsman (primary) Taxonomy 1710I1002X

Record details

NPI number1164635520
Entity typeIndividual (Type 1)
GenderMale
Credentials IDC
Sole proprietorNo
NPI enumeratedMay 8, 2007
Last updated in NPPESJuly 8, 2007
Mailing address1096 Valencia Ct, Virginia Beach, VA 23454-6789

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