Active NPI
Deborah Jerison
- Peer Specialist
- Yellow Springs, OH
National Provider Identifier
1346832821
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 277 Jacoby Rd
Yellow Springs, OH 45387-8792 - Phone
- (937) 689-2926
- NPI assigned
- Feb 6, 2021
- Last updated
- Feb 6, 2021
- 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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | NU | Primary |
Addresses
Primary practice location
277 Jacoby Rd
Yellow Springs, OH 45387-8792
Mailing address
277 Jacoby Rd
Yellow Springs, OH 45387-8792
Phone (937) 689-2926
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2901793 | 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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612569600000",
"number": "1346832821",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "277 JACOBY RD",
"city": "YELLOW SPRINGS",
"state": "OH",
"postal_code": "453878792",
"telephone_number": "937-689-2926"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "277 JACOBY RD",
"city": "YELLOW SPRINGS",
"state": "OH",
"postal_code": "453878792",
"telephone_number": "937-689-2926"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JERISON",
"first_name": "DEBORAH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-02-06",
"last_updated": "2021-02-06",
"certification_date": "2021-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2901793",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yellow Springs, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.