Individual provider Active NPI

Jaqwan T. Cummings, OCPRS

  • Peer Specialist
  • Lakewood, OH
National Provider Identifier
1710865837
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
License
APS.006611 Issued in OH
Practice address
1176 Warren Rd Apt 11
Lakewood, OH 44107-2590
Phone
(216) 776-8178
NPI assigned
Aug 26, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X APS.006611 OH Primary

Addresses

Primary practice location

1176 Warren Rd Apt 11
Lakewood, OH 44107-2590

Mailing address

1176 Warren Rd Apt 11
Lakewood, OH 44107-2590
Phone (216) 776-8178

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

LicenseStateTypeSpecialty
APS.006611OHMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1756166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1710865837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1176 WARREN RD APT 11",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441072590",
            "telephone_number": "216-776-8178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1176 WARREN RD APT 11",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441072590",
            "telephone_number": "216-776-8178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUMMINGS",
        "first_name": "JAQWAN",
        "middle_name": "T.",
        "credential": "OCPRS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-26",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OH",
            "license": "APS.006611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.

Verify at the official NPI Registry.