Eslie Thomas Johnson, PRS, CDCA

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

APS.000798 Issued in OH

Practice address

3445 S Main St
Coventry Township, OH 44319-3028

Phone

(330) 644-4095

Fax

(330) 644-2031

NPI assigned

Jul 21, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1639742273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 S MAIN ST",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443011664",
            "telephone_number": "330-644-4095",
            "fax_number": "330-644-2031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3445 S MAIN ST",
            "city": "COVENTRY TOWNSHIP",
            "state": "OH",
            "postal_code": "443193028",
            "telephone_number": "330-644-4095",
            "fax_number": "330-644-2031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3445 S Main St",
            "address_purpose": "LOCATION",
            "city": "Coventry Twp",
            "state": "OH",
            "postal_code": "443193028",
            "country_code": "US",
            "telephone_number": "330-644-4095",
            "fax_number": "330-645-2031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ESLIE",
        "middle_name": "THOMAS",
        "credential": "PRS, CDCA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-21",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OH",
            "license": "APS.000798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0452494",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandi Hoffman-Westfall
• Christopher Gary Ilijevich, BSN, RN
• Integrated Medicine of Ohio LLC
• Kerry Maureen Jeric, LPCC, CDCA
• Roxana Jimenez
• Nicole Marie Kavali, RN
• Laura Kidd, MA ED., LPCC/LICDC
• Luke Robert Kidd
• KJC Legacy LLC
• KJC Legacy LLC

• Peer Specialist in Coventry Township, OH
• Providers in Coventry Township, OH by specialty
• Peer Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; 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.