Johnson Riverside Family Practice LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

JOHNSON RIVERSIDE FAMILY PRACTICE LLC

Practice address

43 Avenue J
Moore Haven, FL 33471

Phone

(863) 599-1620

NPI assigned

Aug 2, 2021

Last updated

Oct 11, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennifer Nichole Johnson, FNPNPI 1821691544

Title

Aprn

Phone

(863) 946-0284

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer Nichole Johnson, APRN

  • Family Nurse Practitioner
  • Moore Haven, FL
  • NPI 1821691544
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1627862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665446400000",
    "number": "1295409423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 AVENUE J SW",
            "city": "MOORE HAVEN",
            "state": "FL",
            "postal_code": "334712116",
            "telephone_number": "863-946-0284",
            "fax_number": "863-946-0794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 AVENUE J",
            "city": "MOORE HAVEN",
            "state": "FL",
            "postal_code": "33471",
            "telephone_number": "863-599-1620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON RIVERSIDE FAMILY PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-02",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "NICHOLE",
        "authorized_official_title_or_position": "APRN",
        "authorized_official_telephone_number": "863-946-0284",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Anne Heredia
• Benjamin Eduardo Hernandez, NURSE PRACTITIONER
• Kristen L Horn, M.ED, RBT
• Lyonel A. Jean-Baptiste, M.D.
• Harry Jean, FNP-BC
• Jennifer Nichole Johnson, APRN
• Juslain Jonathas
• Emmanuel Noel, M.D.
• Orchid Medical Group LLC
• Eric Palacios, DDS

• Family Medicine Physician in Moore Haven, FL
• Providers in Moore Haven, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.