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

Shannon Johnston

Individual provider Nurse Practitioner · NPI 1902212608

Shannon Johnston is a Nurse Practitioner in Indianapolis, Indiana. Qualified in 2014, 12 years ago. Practices with Mercy Clinic East Communities, a 573-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois, Indiana and Missouri.

Years since qualifying
12
Licensed in
IL, IN, MO
In the registry since
2014
Specialties on file
5
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Practice location Address checks out

675 Justice Way Rm C0049
Indianapolis, IN 46203-1574
Phone: (877) 465-6650
Fax: (804) 294-2775
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 14477 Callaway Ct, Chesterfield, MO 63017-2303 — (314) 692-0703

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 71015147A (IN)
Nurse Practitioner Taxonomy 363L00000X · Licence 2014021871 (MO)
Nurse Practitioner Taxonomy 363L00000X · Licence 209.012733 (IL)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 209.012733 (IL)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 2014021871 (MO)

Record details

NPI number1902212608
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 2, 2014
Last updated in NPPESJuly 31, 2025
Certification dateJuly 31, 2025

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Mercy Clinic East Communities — 573 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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