NPIMap

Organization Active NPI

Henderson Health Care Services, Inc.

Doing business as Sutton Family Practice

  • Family Medicine Physician
  • Sutton, NE
National Provider Identifier
1881708709
Registry record updated Sep 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HENDERSON HEALTH CARE SERVICES, INC.
Doing business as
Sutton Family Practice
Practice address
208 N French Ave
Sutton, NE 68979-2215
Phone
(402) 773-2130
Fax
(402) 723-4520
NPI assigned
Aug 18, 2006
Last updated
Sep 23, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2020

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

Authorized official

Name
Mrs. Jill Ann Myers
Title
Chief Financial Officer
Phone
(402) 723-4512

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

208 N French Ave
Sutton, NE 68979-2215

Mailing address

1621 Front St
Henderson, NE 68371-8902
Phone (402) 773-2130

Other identifiers 2

IdentifierTypeStateIssuer
10025317100MedicaidNE
10025326900MedicaidNE

Other names 1

  • SUTTON FAMILY PRACTICE Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040904000107 NE Part B Supplier - Clinic/Group Practice 4284605700 Receives reassigned benefits from 7 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sutton, NE; Henderson, NE
O20050629000170 NE Part A Provider - Rural Health Clinic 4284605700 Practice locations: Sutton, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881708709. Details of each certification follow.

Rural health clinic certification: CCN 283494

Legal name
HENDERSON HEALTH CARE SERVICES INC
Doing business as
SUTTON FAMILY PRACTICE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 18, 2005
Last certification
Dec 9, 2025
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Sep 15, 1994 in NE
Enrollment address
208 N French Ave
Sutton, NE 68979-2215
Related CCNs
281308

Facilities connected through Provider of Services related, parent or unit certification numbers.

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 1

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
28D1041584Sutton Family Practice208 N French Avenue, Sutton, NE 68979ComplianceFeb 25, 2028

National Provider Directory

National Provider Directory
Tax ID family
Henderson Health Care Inc4 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
Cheryl Brown Individual Corporate DirectorCeo Jan 1, 2009 100%
W-2 Managing EmployeeCeo Jan 1, 2009 100%

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600819200000",
    "number": "1881708709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 FRONT ST",
            "city": "HENDERSON",
            "state": "NE",
            "postal_code": "683718902",
            "telephone_number": "402-773-2130",
            "fax_number": "402-723-4520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 N FRENCH AVE",
            "city": "SUTTON",
            "state": "NE",
            "postal_code": "689792215",
            "telephone_number": "402-773-2130",
            "fax_number": "402-723-4520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDERSON HEALTH CARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "402-723-4512",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025317100",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025326900",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SUTTON FAMILY PRACTICE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sutton, NE

Sources for this page

Verify at the official NPI Registry.