Sibonisiwe Moyo Johnson, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95005225 Issued in CA

Practice address

22555 Alessandro Blvd Ste B
Moreno Valley, CA 92553

Phone

(951) 656-7081

Fax

(951) 656-1710

NPI assigned

Mar 16, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Sibonisiwe Moyo Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mission Grove Medical CorporationGroup PAC ID 3971814484, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mission Grove Medical Corporation

  • Pulmonary Disease Physician
  • Riverside, CA
  • NPI 1205224417

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD Authorized official
• Nephrology Associates Medical Group, Inc.

  • Specialist
  • Riverside, CA
  • NPI 1093264145
  NPD (past)
• PRN Urgent Care, Inc.

  • Urgent Care Clinic/Center
  • Riverside, CA
  • NPI 1366850059
  NPD (past)

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

{
    "created_epoch": "1489622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539043200000",
    "number": "1255872719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22555 ALESSANDRO BLVD STE B",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925538533",
            "telephone_number": "951-656-7081",
            "fax_number": "951-656-1710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22555 ALESSANDRO BLVD STE B",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "92553",
            "telephone_number": "951-656-7081",
            "fax_number": "951-656-1710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16152 ST Antony LN",
            "address_purpose": "LOCATION",
            "city": "Fontana",
            "state": "CA",
            "postal_code": "92336",
            "country_code": "US",
            "telephone_number": "626-354-4036",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16152 ST Antony LN",
            "address_purpose": "LOCATION",
            "city": "Fontana",
            "state": "CA",
            "postal_code": "92336",
            "country_code": "US",
            "telephone_number": "626-354-4036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SIBONISIWE",
        "middle_name": "MOYO",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-16",
        "last_updated": "2018-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95005225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SIBONISIWE",
            "last_name": "MOYO",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joshua Riley Johnson, PA-C
• Kelsey Marie Johnson
• Marsha Y Johnson, M.S.
• Priscilla E Johnson
• Shavonda Johnson, NP
• Tehrisa Anne Johnson
• Truitt Lamar Johnson, PHYSICAL THERAPIST
• Alisha Jones
• Anita Louise Jones
• Charles Franklin Jones Jr., LPT

• Nurse Practitioner in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.