Derek Lee Johnson

Key facts

NPI

1225820103

Entity type

Individual (NPI type 1)

Primary specialty

Home Health Aide 374U00000X

Practice address

960 Chestnut Ridge Rd Apt 208
Morgantown, WV 26505-1509

Phone

(304) 888-3107

NPI assigned

May 19, 2025

Sex

Male

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 19, 2025.

{
    "created_epoch": "1747612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747612800000",
    "number": "1225820103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 FIVE FORKS DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265089024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 CHESTNUT RIDGE RD APT 208",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265051509",
            "telephone_number": "304-888-3107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DEREK",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-19",
        "last_updated": "2025-05-19",
        "certification_date": "2025-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

• Britany Nicole Johnson
• Candiance Johnson
• Caprice Johnson, CRNA
• Darlene Johnson
• David R Johnson, CRNA
• Edgar Lee Johnson
• Edgar Lee Johnson Jr.
• Eric Martin Johnson, AU.D., PH.D.
• Erica Johnson
• Haley Ramsey Johnson, BCBA

All providers in Morgantown, WV · Home Health Aide in West Virginia