NPIMap

Organization Active NPI

Henderson Operating Group LLC

  • Skilled Nursing Facility
  • Henderson, TN
National Provider Identifier
1235664814
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
HENDERSON OPERATING GROUP LLC
Practice address
412 Juanita Dr
Henderson, TN 38340-1949
Phone
(731) 989-7598
NPI assigned
Apr 20, 2017
Last updated
Apr 20, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

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

Authorized official

Name
Anshel Niederman
Title
Manager
Phone
(917) 682-3129

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

412 Juanita Dr
Henderson, TN 38340-1949

Mailing address

544 Park Ave
Ste B04
Brooklyn, NY 11205-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170621002068 TN Part A Provider - Skilled Nursing Facility 7517235286 Practice locations: Henderson, TN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1235664814. Details of each certification follow.

Skilled nursing facility certification: CCN 445471

Legal name
HENDERSON OPERATING GROUP LLC
Doing business as
HENDERSON HEALTH & REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 1, 2003
Last certification
Aug 2, 2024
Beds
132
Ownership / control type
Corporation
Multi-facility organization
AHAVA
Organization structure
LLCProprietary
Enrollment address
412 Juanita Dr
Henderson, TN 38340-1949
Nursing home name
HENDERSON HEALTH AND REHABILITATION CENTER
Affiliated entity
AHAVA HEALTHCARE

Care Compare: Nursing home

Medicare Care Compare
Listed as
Henderson Health And Rehabilitation CenterCCN 445471 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Apr 1, 2003
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
13280.7 residents per day on average
Chain
Ahava Healthcare16 facilities in the chain
Penalties (3 years)
1Fines totaling $81,328

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
44D0951485Henderson Operating Group LLC412 Juanita Drive, Henderson, TN 38340Certificate of waiverSep 20, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Benjamin Neuman Individual 5% Or Greater Direct Ownership Interest Apr 28, 2017 10%
James D King Individual Operational/Managerial Control Nov 2, 2022
Adp of the SNF Mar 27, 2025
Shiya Labin Individual 5% Or Greater Direct Ownership Interest Apr 28, 2017 7.5%
Eric Gaston Jones Individual Operational/Managerial Control Oct 23, 2023
Adp of the SNF Mar 27, 2025
Organization, Brooklyn, NY Chain home office Adp of the SNF Mar 27, 2025
Anshel Niederman Individual 5% Or Greater Direct Ownership Interest Apr 28, 2017 30%
Corporate OfficerManager Apr 28, 2017
Managing Control - Governing Body Jun 1, 2019
Organization, Jackson, TN LLC Adp of the SNF Mar 27, 2025
Philipson Family Limited Liability Company, LLC Organization, Spring Valley, NY LLC 5% Or Greater Direct Ownership Interest Apr 28, 2017 42.5%
Organization, Pensacola, FL Adp of the SNF Mar 27, 2025
Mce Associates LLC Organization, Brooklyn, NY LLC, For-profit 5% Or Greater Direct Ownership Interest Apr 28, 2017 10%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 27

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 27

Practitioners & affiliated clinicians

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.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1492646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492646400000",
    "number": "1235664814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "544 PARK AVE",
            "address_2": "STE B04",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112051600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 JUANITA DR",
            "city": "HENDERSON",
            "state": "TN",
            "postal_code": "383401949",
            "telephone_number": "731-989-7598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDERSON OPERATING GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-20",
        "last_updated": "2017-04-20",
        "status": "A",
        "authorized_official_last_name": "NIEDERMAN",
        "authorized_official_first_name": "ANSHEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "917-682-3129"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, TN

Sources for this page

Verify at the official NPI Registry.