Johnathan Brandon Wellington

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

550006383 Issued in CA

Practice address

25400 Alessandro Blvd Ste 102
Moreno Valley, CA 92553-4319

Phone

(951) 750-0117

NPI assigned

Sep 5, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Shortstayrentals LLC

  dba Angels Home Care Providers

  • Home Health Agency
  • Moreno Valley, CA
  • NPI 1699408518
  NPD

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

{
    "created_epoch": "1630800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630800000000",
    "number": "1225706096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27882 DE LA VALLE DR",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925555917",
            "telephone_number": "951-750-0117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25400 ALESSANDRO BLVD STE 102",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925534319",
            "telephone_number": "951-750-0117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLINGTON",
        "first_name": "JOHNATHAN",
        "middle_name": "BRANDON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-05",
        "last_updated": "2021-09-05",
        "certification_date": "2021-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "550006383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Weiner, PA
• Keli-Rae Weisenberger, LCSW
• Timothy Weiss
• Niedha Welch
• Glenda Faith Wellington, RN
• Randall Duke Lealofi Wendt Olo, RN
• Bruce Weng
• Karen Wesolowski, PT
• La Wanda West, LVN
• Western Dental Services, Inc.

• Home Health Agency in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.