Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Shannon Lee Johnson, PA-C

Individual provider Physician Assistant · NPI 1750566790

Mrs. Shannon Lee Johnson, PA-C is a Physician Assistant in Davenport, Iowa. Qualified in 2007, 19 years ago. Practices with Genesis Health System, a 262-clinician group and accepts Medicare assignment. Licensed in Iowa and Illinois.

Years since qualifying
19
Licensed in
IA, IL
In the registry since
2008
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1228 E Rusholme St Mob 1 Ste 3020
Davenport, IA 52803
Phone: (563) 421-7540
Fax: (563) 421-7549
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 002328 (IA)
Physician Assistant Taxonomy 363A00000X · Licence 085003168 (IL)

Record details

NPI number1750566790
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 9, 2008
Last updated in NPPESOctober 12, 2021
Certification dateOctober 12, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Genesis Health System — 262 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Davenport