Organization Active NPI

Henderson Health Services Family Nurse Practitioner PLLC

  • Primary Care Clinic/Center
  • White Plains, NY
National Provider Identifier
1417509357
Registry record updated Oct 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
HENDERSON HEALTH SERVICES FAMILY NURSE PRACTITIONER PLLC
Practice address
75 S Broadway FL 4
White Plains, NY 10601-4413
Phone
(191) 420-0427
NPI assigned
Jul 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2021

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

Authorized official

Name
Sebrina Henderson, FNP-BC
Title
Family Nurse Practitioner
Phone
(917) 359-4375

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

75 S Broadway FL 4
White Plains, NY 10601-4413

Mailing address

75 S Broadway FL 4
White Plains, NY 10601-4413
Phone (914) 200-4275

Other identifiers 1

IdentifierTypeStateIssuer
04726798MedicaidNY

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634256000000",
    "number": "1417509357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 S BROADWAY FL 4",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106014413",
            "telephone_number": "914-200-4275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 S BROADWAY FL 4",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106014413",
            "telephone_number": "191-420-0427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDERSON HEALTH SERVICES FAMILY NURSE PRACTITIONER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-11",
        "last_updated": "2021-10-15",
        "certification_date": "2021-09-28",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "SEBRINA",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "917-359-4375",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04726798",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.