Individual provider Active NPI

Jenary Lynn Johnson, R.N.

  • Registered Nurse
  • Canton, OH
National Provider Identifier
1003205212
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN356919 Issued in OH
Practice address
1000 Chapel RDG NE
Canton, OH 44714-2752
Phone
(330) 265-3203
NPI assigned
Jan 12, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN356919 OH Primary

Addresses

Primary practice location

1000 Chapel RDG NE
Canton, OH 44714-2752

Mailing address

1000 Chapel RDG NE
Canton, OH 44714-2752
Phone (330) 265-3203

Other practice location 1

1416 37th St NE Apt A
Canton, OH 44714-1345
Phone (330) 265-3203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN356919OHMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Jerrels Home Cares CurrentSince Jan 31, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1421020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1003205212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 CHAPEL RDG NE",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447142752",
            "telephone_number": "330-265-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CHAPEL RDG NE",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447142752",
            "telephone_number": "330-265-3203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1416 37th St NE Apt A",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "447141345",
            "country_code": "US",
            "telephone_number": "330-265-3203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JENARY",
        "middle_name": "LYNN",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-12",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN356919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.