Individual provider Active NPI

Jennifer R Johnson, FNP

  • Nurse Practitioner
  • Warrenville Heights, OH
National Provider Identifier
1821646423
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
024582 Issued in OH
Practice address
20050 Havard Ave
Warrenville Heights, OH 44122-6805
Phone
(216) 491-6438
Fax
(216) 491-7088
NPI assigned
Aug 28, 2019
Last updated
Feb 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 024582 OH Primary
Family Nurse Practitioner 363LF0000X 024582 OH

Addresses

Primary practice location

20050 Havard Ave
Warrenville Heights, OH 44122-6805

Mailing address

2570 Som Center Rd
Willoughby Hills, OH 44094-9607

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://npiregistry.cms.hhs.gov/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200305002915 OH Practitioner - Nurse Practitioner 0547697427 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-2200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
024582OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wooster Clinic, LLC CurrentSince Dec 7, 2024 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Dec 25, 2019 Accepting new patients

Locations

551 Washington St
Chagrin Falls, OH 44022
Phone (440) 893-9393

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

2570 Som Center Rd
Willoughby Hills, OH 44094
Phone (440) 943-2500

1740 Cleveland Rd
Wooster, OH 44691
Phone (330) 287-4500

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1821646423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2570 SOM CENTER RD",
            "city": "WILLOUGHBY HILLS",
            "state": "OH",
            "postal_code": "440949607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20050 HAVARD AVE",
            "city": "WARRENVILLE HEIGHTS",
            "state": "OH",
            "postal_code": "441226805",
            "telephone_number": "216-491-6438",
            "fax_number": "216-491-7088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JENNIFER",
        "middle_name": "R",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-28",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "024582",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "024582",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://npiregistry.cms.hhs.gov/",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2570 Som Center Rd",
            "city": "Willoughby Hills",
            "state": "OH",
            "country_code": "US",
            "postal_code": "440949607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.