Active NPI
Jermaine Johnson
- Peer Specialist
- Elyria, OH
National Provider Identifier
1376415620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- APS.005566
- Practice address
- 120 Hayes Ave
Elyria, OH 44035-3534 - Phone
- (440) 420-6942
- NPI assigned
- Sep 18, 2025
- Sex
- Male
- 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 | APS.005566 | OH | Primary |
Addresses
Primary practice location
120 Hayes Ave
Elyria, OH 44035-3534
Mailing address
120 Hayes Ave
Elyria, OH 44035-3534
Phone (440) 420-6942
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APS.005566 | OH | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1758153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758153600000",
"number": "1376415620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 HAYES AVE",
"city": "ELYRIA",
"state": "OH",
"postal_code": "440353534",
"telephone_number": "440-420-6942"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 HAYES AVE",
"city": "ELYRIA",
"state": "OH",
"postal_code": "440353534",
"telephone_number": "440-420-6942"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "JERMAINE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-09-18",
"last_updated": "2025-09-18",
"certification_date": "2025-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "OH",
"license": "APS.005566",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elyria, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.