Derek Kyrk Johnson

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

PRS008272 Issued in OH

Practice address

6100 Oak Tree Blvd
Independence, OH 44131-2544

Phone

(216) 202-8224

NPI assigned

Sep 24, 2026

Last updated

Sep 24, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1790208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1023921665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 OAK TREE BLVD STE 241",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312544",
            "telephone_number": "216-202-8224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 OAK TREE BLVD",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312544",
            "telephone_number": "216-202-8224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DEREK",
        "middle_name": "KYRK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-09-24",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Peer Specialist",
            "state": "OH",
            "license": "PRS008272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teniyah Jenkins
• Amadea Jennings
• Jason Paul Jeran, D.M.D.
• Kyle Jerman
• Ruth Jerome, MACCC/SLP
• Janice I Johnson, CNS
• Tikita Lavette Johnson, LPN
• Chasiti Jones, RN
• Garrick Jones
• Kathryn Mildred Jones, PH.D.

• Peer Specialist in Independence, OH
• Providers in Independence, OH by specialty
• Peer Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.