Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Jacob M Johnston

Individual provider Registered Nurse · NPI 1972175321

Mr. Jacob M Johnston is a Certified Registered Nurse Anesthetist (CRNA) in Melbourne, Kentucky. Graduated from University of Cincinnati College of Medicine in 2022, 4 years ago. Practices with University of Cincinnati Physicians Company LLC, a 1,476-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
4
Trained at
University of Cincinnati College of Medicine
Licensed in
OH
In the registry since
2021

Practice location Address checks out

3543 Providence Trace Dr
Melbourne, KY 41059-9203
Phone: (513) 675-2612
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Nurse (primary) Taxonomy 163W00000X · Licence 438891 (OH)

Record details

NPI number1972175321
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 14, 2021
Last updated in NPPESJuly 14, 2021
Certification dateJuly 14, 2021
Mailing address3543 Providence Trace Dr, Melbourne, KY 41059-9203

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolUNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE
Graduated 2022 (4 years in practice)
Group practice University Of Cincinnati Physicians Company Llc — 1476 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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