Shantae Johnson, AGACNP-BC
NPI 1417406752 · Acute Care Nurse Practitioner · Detroit, MI
Enrolled with Medicare as Practitioner - Nurse Practitioner · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Shantae Johnson, AGACNP-BC is a Acute Care Nurse Practitioner provider in Detroit, MI (NPI 1417406752).
Provider details
- NPI number
- 1417406752
- Entity type
- Individual
- Primary specialty
- Acute Care Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- AGACNP-BC
- Sex
- Female
- Sole proprietor
- Yes
- License
- 4704245204 (MI)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure33% of score
9 yrs in NPPES registry
- Profile completeness33% of score
100% of core fields populated
- Practice footprint20% of score
2 documented practice locations
- Open Payments transparency13% of score
Has Open Payments disclosures (2024)
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$125 across 2 records (Open Payments 2024)
Open Payments discloses payments and transfers of value (meals, travel, consulting, research, royalties) from drug and device makers to providers. This is a transparency signal, not a verdict — such payments are legal and common, and their presence is neither an endorsement nor a criticism. Source: CMS Open Payments, program year 2024.
Practice location
Mailing address
Additional practice locations (1)
- 6071 W Outer DrDetroit, MI 48235-2624Phone: (313) 966-6075
Registry dates
- Enumerated
- 2016-09-28
- Last updated
- 2025-07-29
- Certified
- 2025-07-29
Frequently asked questions
- What is Shantae Johnson's NPI number?
- Shantae Johnson's National Provider Identifier (NPI) is 1417406752, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Shantae Johnson's specialty?
- Shantae Johnson is listed in the NPPES registry with a primary specialty of Acute Care Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Shantae Johnson located?
- Shantae Johnson's practice location on file with NPPES is 100 Mack Ave Fl 1, Detroit, MI 48201-2416.
- What is Shantae Johnson's phone number?
- The practice phone number listed in the NPPES registry for Shantae Johnson is (313) 818-8207.
- Does Shantae Johnson accept Medicare?
- Shantae Johnson is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Shantae Johnson's NPI active?
- Yes — Shantae Johnson's NPI (1417406752) is active in the NPPES registry as of the last update on 2025-07-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.