Active NPI
Tiara Lachelle Johnson
- Home Health Agency
- Maple Heights, OH
National Provider Identifier
1104420181
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Nov 20, 2024.
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Practice address
- 20601 Watson Rd
Maple Heights, OH 44137-2031 - Phone
- (216) 971-0831
- NPI assigned
- Nov 30, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | Primary |
Addresses
Primary practice location
20601 Watson Rd
Maple Heights, OH 44137-2031
Mailing address
20601 Watson Rd
Maple Heights, OH 44137-2031
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0344184 | Medicaid | OH |
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606694400000",
"number": "1104420181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20601 WATSON RD",
"city": "MAPLE HEIGHTS",
"state": "OH",
"postal_code": "441372031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20601 WATSON RD",
"city": "MAPLE HEIGHTS",
"state": "OH",
"postal_code": "441372031",
"telephone_number": "216-971-0831"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "TIARA",
"middle_name": "LACHELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-30",
"last_updated": "2020-11-30",
"certification_date": "2020-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0344184",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Maple Heights, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.