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JOHNSON RIVERSIDE FAMILY PRACTICE LLC
NPI 1295409423
Family Medicine in Moore Haven, FL

Active since August 02, 2021CLIA 10D2335306 · Waiver
43 AVENUE J, MOORE HAVEN, FL 33471(863) 599-1620 Get Directions Write a Review

NPPES record last updated: October 11, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 11, 2022, Sep 17, 2021, Aug 2, 2021 (3 updates tracked since 2021).

About Johnson Riverside Family Practice Llc NPPES

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

JOHNSON RIVERSIDE FAMILY PRACTICE LLC (NPI 1295409423) is a healthcare organization registered as a family medicine in Moore Haven, Florida and active in the NPI registry since August 2021. The organization holds a CLIA Waiver certificate valid through December 8, 2027 and lists Jennifer Nichole Johnson, Aprn, as its authorized official.

NPPES Registry Identity

NPI1295409423
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameJOHNSON RIVERSIDE FAMILY PRACTICE LLC
Location Address43 AVENUE JMoore Haven, FL 33471
Mailing Address43 Avenue J SwMoore Haven, FL 33471-2116 · (863) 946-0284 · Fax (863) 946-0794
Phone(863) 599-1620
Organization SubpartNo
Authorized OfficialJennifer Nichole JohnsonAprn · (863) 946-0284
Enumeration DateAugust 2, 2021
Last NPPES UpdateOctober 11, 20223 updates tracked since enumeration
NPPES CertifiedOctober 11, 2022
✔ NPI 1295409423 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
43 AVENUE J, Moore Haven, FL 33471
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2335306

Johnson Riverside Family Practice LLC · Moore Haven, FL
Active · expires Dec 8, 2027
CLIA Number10D2335306
Laboratory TypePhysician Office
Certificate Effective DateDecember 9, 2025
Certificate Expiration DateDecember 8, 2027
Laboratory DirectorJennifer Nichole Johnson
Laboratory Phone(863) 946-0284
Laboratory LocationJohnson Riverside Family Practice LLC43 Avenue J SW, Moore Haven, FL 33471
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Johnson Riverside Family Practice LLC's NPI number?

The NPI number for Johnson Riverside Family Practice LLC is 1295409423. It was assigned to this organization in the NPPES registry on August 2, 2021.

Where is Johnson Riverside Family Practice LLC located?

Johnson Riverside Family Practice LLC is located at 43 Avenue J, Moore Haven, FL 33471. The listed phone number is (863) 599-1620.

What is Johnson Riverside Family Practice LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Johnson Riverside Family Practice LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2335306) is associated with this NPI, valid through December 8, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Johnson Riverside Family Practice LLC was last updated on October 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.