NPIMap

Organization Active NPI

Greater Sandhills Family Healthcare, PC

  • Family Medicine Physician
  • Atkinson, NE
National Provider Identifier
1902091671
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
22198 Issued in NE
Legal business name
GREATER SANDHILLS FAMILY HEALTHCARE, PC
Practice address
418 E 5TH St
Atkinson, NE 68713-4885
Phone
(402) 925-2994
Fax
(402) 925-2996
NPI assigned
Sep 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 22198 NE Primary

Addresses

Primary practice location

418 E 5TH St
Atkinson, NE 68713-4885

Mailing address

PO Box 403
Atkinson, NE 68713-0403
Phone (402) 924-3660

Other identifiers 1

IdentifierTypeStateIssuer
10025549600MedicaidNE

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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
O20070921000768 NE Part A Provider - Rural Health Clinic 4587757661 Practice locations: Atkinson, NE

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902091671. Details of each certification follow.

Rural health clinic certification: CCN 283867

Legal name
GREATER SANDHILLS FAMILY HEALTHCARE PC
Doing business as
GREATER SANDHILLS FAMILY HEALTHCARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Mar 6, 2008
Last certification
Oct 22, 2019
Ownership / control type
1B
Organization structure
CorporationProprietary
Incorporated
Jun 19, 2007 in NE
Enrollment address
418 E 5TH St
Atkinson, NE 68713-4885

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.

National Provider Directory

National Provider Directory
Tax ID family
Greater Sandhills Family Healthcare 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 2

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

NameRoleSinceShare
Greater Sandhills Family Healthcare PC Organization, Stuart, NE For-profit 5% Or Greater Direct Ownership Interest Jul 14, 2007 100%
John D Tubbs Individual 5% Or Greater Direct Ownership InterestCeo, President Jul 14, 2007
W-2 Managing EmployeePhysician, Medical Director Jul 14, 2007 51%

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 1

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

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 1

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 2

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": "1189036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1902091671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 403",
            "city": "ATKINSON",
            "state": "NE",
            "postal_code": "687130403",
            "telephone_number": "402-924-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 E 5TH ST",
            "city": "ATKINSON",
            "state": "NE",
            "postal_code": "687134885",
            "telephone_number": "402-925-2994",
            "fax_number": "402-925-2996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER SANDHILLS FAMILY HEALTHCARE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-06",
        "last_updated": "2022-07-21",
        "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": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "22198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025549600",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atkinson, NE

Sources for this page

Verify at the official NPI Registry.