NPIMap

Individual provider Active NPI

Sara E Henderson, APRN

  • Family Nurse Practitioner
  • Jeffersonville, IN
National Provider Identifier
1568055929
Registry record updated Nov 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3015246 Issued in KY
Practice address
101 Hospital Blvd
Jeffersonville, IN 47130-3769
Phone
(812) 282-3899
Fax
(812) 282-4172
NPI assigned
Feb 17, 2021
Last updated
Nov 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3015246 KY
Family Nurse Practitioner 363LF0000X 3015246 KY Primary

Addresses

Primary practice location

101 Hospital Blvd
Jeffersonville, IN 47130-3769

Mailing address

101 Hospital Blvd
Jeffersonville, IN 47130-3769
Phone (812) 282-3899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210301001670 KY Practitioner - Nurse Practitioner 5294141115 Reassigns benefits to 1 organization
I20210317001065 IN Practitioner - Nurse Practitioner 5294141115 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Louisville School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
First Urology PSCGroup PAC ID 3779572888, 56 clinicians

Practice addresses (Care Compare)

101 Hospital Blvd
Jeffersonville, IN 47130-3769
Phone (812) 282-3899

300 High Point CT
Mount Washington, KY 40047-6560
Phone (502) 955-6129

3920 S Dupont SQ C
Louisville, KY 40207-4615
Phone (812) 282-3899

5120 Dixie Hwy
Suite 105
Louisville, KY 40216-1775
Phone (812) 282-3899

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
First Urology, PSC Nurse Practitioner CurrentSince Mar 1, 2021 Accepting new patients

Locations

3431 Solutions Ctr
Chicago, IL 60677

101 Hospital Blvd
Jeffersonvlle, IN 47130
Phone (812) 206-8196

3920 S DuPont Sq
Louisville, KY 40207
Phone (502) 206-8132

3920 S DuPont Sq
Ste C
Louisville, KY 40207
Phone (502) 721-0116

300 High Point Ct
Mt Washington, KY 40047
Phone (502) 447-4595

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637020800000",
    "number": "1568055929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HOSPITAL BLVD",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303769",
            "telephone_number": "812-282-3899",
            "fax_number": "812-282-4172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HOSPITAL BLVD",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303769",
            "telephone_number": "812-282-3899",
            "fax_number": "812-282-4172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "SARA",
        "middle_name": "E",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-17",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3015246",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3015246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersonville, IN

Sources for this page

Verify at the official NPI Registry.