DOMINIC DWAYNE JOHNSON
NPI 1104618529
Community Health Worker in Carbondale, IL

Active since May 21, 2025
300 W OAK ST, CARBONDALE, IL 62901(217) 891-9662 Get Directions Write a Review

NPPES record last updated: May 21, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dominic Dwayne Johnson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DOMINIC DWAYNE JOHNSON (NPI 1104618529) is an individual community health worker in Carbondale, Illinois and active in the NPI registry since May 2025.

NPPES Registry Identity

NPI1104618529
Entity TypeIndividualMale
Primary Taxonomy172V00000X
Provider Legal NameDOMINIC DWAYNE JOHNSON
Location Address300 W OAK STCarbondale, IL 62901-1400
Mailing Address300 W Oak StCarbondale, IL 62901-1400 · (217) 891-9662
Sole ProprietorNo
Enumeration DateMay 21, 2025
NPPES CertifiedMay 21, 2025
NPI 1104618529 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCommunity Health WorkerOther Service Providers
Taxonomy Code172V00000X
Definition
Community health workers (CHW) are lay members of communities who work either for pay or as volunteers in association with the local health care system in both urban and rural environments and usually share ethnicity, language, socioeconomic status and life experiences with the community members they serve. They have been identified by many titles such as community health advisors, lay health advocates, promotores(as), outreach educators, community health representatives, peer health promoters, and peer health educators. CHWs offer interpretation and translation services, provide culturally appropriate health education and information, assist people in receiving the care they need, give informal counseling and guidance on health behaviors, advocate for individual and community health needs, and provide some direct services such as first aid and blood pressure screening. Some examples of these practitioners are Community Health Aides or Practitioners established under 25 USC 1616 (l) under HHS, Indian Health Service, Public Health Service.
300 W OAK ST, Carbondale, IL 62901

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physician Assistant
300 W OAK ST
CARBONDALE, IL 62901
Physician Assistant
300 W OAK ST
CARBONDALE, IL 62901
Physician Assistant
300 W OAK ST
CARBONDALE, IL 62901
Family Medicine
300 W OAK ST
CARBONDALE, IL 62901
Family Medicine
300 W OAK ST
CARBONDALE, IL 62901
Family Medicine
300 W OAK ST
CARBONDALE, IL 62901
Family Medicine
300 W OAK ST
CARBONDALE, IL 62901
Family Medicine
300 W OAK ST
CARBONDALE, IL 62901

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dominic Johnson's NPI number?

The NPI number for Dominic Johnson is 1104618529. It was assigned to this individual provider in the NPPES registry on May 21, 2025.

Where is Dominic Johnson located?

Dominic Johnson practices at 300 W Oak St, Carbondale, IL 62901. The listed phone number is (217) 891-9662.

What is Dominic Johnson's specialty?

The primary specialty registered for this NPI is Community Health Worker with taxonomy code 172V00000X.

When was this NPI record last updated?

The NPPES record for Dominic Johnson was last updated on May 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.