Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1336929884 Individual Practitioner Male Practitioner

Johnny Jackson

Peer Specialist • Fairfield, OH

Professional Overview & Biography Verified Profile Summary

Johnny Jackson is a registered healthcare professional specializing in Peer Specialist in Fairfield, OH. Practice services are available at 6570 SOSNA DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

6570 Sosna Dr

Fairfield, OH 450142222

Telephone 5139424673
Fax 5138601439
Associated Practice Facility / Clinic
🏢 Decoach Team Llc Facility NPI 1366992224

Specialty Benchmarks & Practice Insights

Comparative analytics for Peer Specialist in Fairfield, OH

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 6.5 Yrs
Regional Practice Density
4 Specialists

Practicing in Fairfield, OH (3139 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-11-16
Peer Specialist Primary Specialty

NUCC Taxonomy Code: 175T00000X

State License OH APS.004453

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Case Manager/Care Coordinator

NUCC Taxonomy Code: 171M00000X

A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Hayley Lemmel

Case Manager/Care Coordinator

NPI 1033787908
Murile Morgan

Counselor - Addiction (Substance Use Disorder)

NPI 1043987142
NPI 1063087104
Dr. Rick Hum , MD

Internal Medicine

NPI 1063780799

Doctor of Medicine (M.D.)

Larry Mcculler

Counselor - Addiction (Substance Use Disorder)

NPI 1083247258
Tracie Faheem

Case Manager/Care Coordinator

NPI 1093482192

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
📍
Updated Business Mailing Address October 30, 2023

Registered at 100 CROWNE POINT PL, CINCINNATI, OH 452415427 (Tel: 5137437628)

NPI Profile Active October 03, 2023

NPI status registered as active in NPPES database

📍
Updated Practice Location October 03, 2023

Registered at 6570 SOSNA DR, FAIRFIELD, OH 450142222 (Tel: 5139424673)

📍
Updated Business Mailing Address October 03, 2023

Registered at 3103 DIXIE HWY, HAMILTON, OH 450151653 (Tel: 5138924673)

👤
Provider Name / Credentials Updated October 03, 2023

Recorded as JOHNNY JACKSON

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 03, 2023

Peer Specialist (License #APS.004453 in OH)

🟢
Initial NPI Registration & Enumeration October 03, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1336929884
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 03, 2023
Last Update: November 16, 2023
Sole Proprietor: Yes

Mailing Address

100 Crowne Point Pl

Cincinnati, OH 452415427

Phone: 5137437628

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.