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Jacqueline M Johnson , LPN

Licensed Practical Nurse β€’ Lorain, OH

Active NPI 1962384636 Individual Practitioner Female Practitioner
Practice location in NPPES

6140 S Broadway
Lorain, OH 440533821

Call 4402337232 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

6140 S Broadway

Lorain, OH 440533821

Telephone 4402337232
Fax 4402339070
Organization at the Same NPPES Address or Phone
Riveon Mental Health And Recovery Facility NPI 1841268281

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2025

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Lorain and Ohio

117 active clinicians are listed under Licensed Practical Nurse with a practice address in Lorain, OH (12,649 in Ohio).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Lorain

0% of these 117 clinicians have the CMS telehealth indicator.

0% of these 117 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-02-05
Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

License # reported to NPPES OH LPN.189335

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: State Medical Board of Ohio.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
0163668 (OH)

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

4 listed
Dr. Lorraine Christian , MD

Family Medicine - Adolescent Medicine

NPI 1376682104

Doctor of Medicine (M.D.)

Dr. Dominic Gomes , MD

Family Medicine - Adult Medicine

NPI 1144376856

Doctor of Medicine (M.D.)

Dr. Sunita Mathew , DO

Psychiatry & Neurology - Child & Adolescent Psychiatry

NPI 1265607444

Doctor of Osteopathic Medicine (D.O.)

Dr. Achala Patel , MD

Psychiatry & Neurology - Child & Adolescent Psychiatry

NPI 1366581035

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location February 05, 2026

Registered at 6140 S BROADWAY, LORAIN, OH 440533821 (Tel: 4402337232)

πŸ“
Updated Business Mailing Address February 05, 2026

Registered at 6140 S BROADWAY, LORAIN, OH 440533821 (Tel: 4402337232)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) February 05, 2026

Licensed Practical Nurse (license number reported to NPPES: OH LPN.189335)

βœ…
NPI Profile Active July 23, 2025

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) July 23, 2025

Registered at 9404 N CHURCH DR APT 115, PARMA HEIGHTS, OH 441304788 (Tel: 2164663606)

πŸ“
Business Mailing Address (Initial Record) July 23, 2025

Registered at 9404 N CHURCH DR APT 115, PARMA HEIGHTS, OH 441304788 (Tel: 2164663606)

πŸ‘€
Provider Name / Credentials (Initial Record) July 23, 2025

Recorded as JACQUELINE JOHNSON, LPN

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 23, 2025

Licensed Practical Nurse (license number reported to NPPES: OH 189335)

🟒
Initial NPI Registration & Enumeration July 23, 2025

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1962384636
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 23, 2025
Last Update: February 05, 2026
Sole Proprietor: Yes

Mailing Address

6140 S Broadway

Lorain, OH 440533821

Phone: 4402337232

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.