NPIMap

Organization Active NPI

Greater Sandhills Family Healthcare, PC

  • Family Medicine Physician
  • Bassett, NE
National Provider Identifier
1295920981
Registry record updated Jan 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GREATER SANDHILLS FAMILY HEALTHCARE, PC
Practice address
101 E South Street
Bassett, NE 68714-0146
Phone
(402) 684-2285
Fax
(402) 684-2299
NPI assigned
Sep 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2012

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

Authorized official

Name
Dr. John D Tubbs, M.D.
Title
President
Phone
(402) 924-3660

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

101 E South Street
Bassett, NE 68714-0146

Mailing address

PO Box 146
Bassett, NE 68714-0146
Phone (402) 684-2285

Other identifiers 2

IdentifierTypeStateIssuer
10025616100OtherNERHC MEDICAID
10025535900MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070905000708 NE Part A Provider - Rural Health Clinic 4587757661 Practice locations: Bassett, NE
O20070913000630 NE Part B Supplier - Clinic/Group Practice 4587757661 Receives reassigned benefits from 7 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bassett, NE; Stuart, NE; Atkinson, NE

Rural health clinic certification: CCN 283866

Legal name
GREATER SANDHILLS FAMILY HEALTHCARE PC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 1, 2008
Last certification
Oct 23, 2019
Ownership / control type
1B
Organization structure
CorporationProprietary
Incorporated
Jun 21, 2007 in NE
Enrollment address
101E South St
Bassett, NE 68714-5508

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
28D1072377Greater Sandhills Family Healthcare101 E South Street, Bassett, NE 68714Certificate of waiverAug 14, 2027

National Provider Directory

National Provider Directory
Tax ID family
Greater Sandhills Health PC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 1

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

NameRoleSinceShare
John D Tubbs Individual 5% Or Greater Direct Ownership InterestDirector/Officer/Ceo Jul 14, 2007 100%
Corporate OfficerSecretary Jun 21, 2007 100%
Corporate DirectorPresident/ Treasurer Jun 21, 2007 100%
W-2 Managing EmployeeAd;MD; Jul 14, 2007 100%

Owners & managing parties with NPI records 1

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

  • John D Tubbs, M.D.
    • Family Medicine Physician
    • Stuart, NE
    • NPI 1104812270

    5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, W-2 Managing Employee

    CMS ownership

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
StuartStuart, NE, CCN 283865 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 14, 2007
Greater Sandhills Family HealthcareAtkinson, NE, CCN 283867 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jul 14, 2007

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326067200000",
    "number": "1295920981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 146",
            "city": "BASSETT",
            "state": "NE",
            "postal_code": "687140146",
            "telephone_number": "402-684-2285",
            "fax_number": "402-684-2299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E SOUTH STREET",
            "city": "BASSETT",
            "state": "NE",
            "postal_code": "687140146",
            "telephone_number": "402-684-2285",
            "fax_number": "402-684-2299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER SANDHILLS FAMILY HEALTHCARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-06",
        "last_updated": "2012-01-09",
        "status": "A",
        "authorized_official_last_name": "TUBBS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-924-3660",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RHC MEDICAID",
            "identifier": "10025616100",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025535900",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bassett, NE

Sources for this page

Verify at the official NPI Registry.