Kelly Lynn Johnson

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

19051 Woodward Rd
Fayetteville, OH 45118-8467

Phone

(513) 706-3306

NPI assigned

Dec 3, 2025

Last updated

Mar 2, 2026By the provider in NPPES

Sex

Unspecified or another gender identity

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Phoenix Center, Inc.

  dba TPC Wellness

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Ironton, OH
  • NPI 1225670813

  Single Specialty

  NPD
• Phoenix Center, Inc.

  dba TPC Wellness

  • General Practice Physician
  • Ironton, OH
  • NPI 1366379075

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1764720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1578426920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19051 WOODWARD RD",
            "city": "FAYETTEVILLE",
            "state": "OH",
            "postal_code": "451188467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19051 WOODWARD RD",
            "city": "FAYETTEVILLE",
            "state": "OH",
            "postal_code": "451188467",
            "telephone_number": "513-706-3306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2025-12-03",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": null,
            "primary": true
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OH",
            "license": "APS.007197",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fayetteville-Perry Local Schools
• Brittany Noel Hall
• Katherine J Hauke
• Kristina W. Hesser, R.N.
• Bertha Ann Hooley
• Dale Anthony Kirby
• Morgan Klette
• Matt Joseph Landock
• Kathleen Mason, OT
• Michael McCafferty

• Case Manager/Care Coordinator in Fayetteville, OH
• Providers in Fayetteville, OH by specialty
• Case Manager/Care Coordinator in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.