Active NPI
Henderson Health Services Family Nurse Practitioner PLLC
- Primary Care Clinic/Center
- White Plains, NY
National Provider Identifier
1417509357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04726798 | Medicaid | NY |
National Provider Directory
National Provider DirectoryNPI 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.