HENRIETTA JOHNSON MEDICAL CENTER
NPI 1770699621
Clinic/Center - Federally Qualified Health Center (FQHC) in Wilmington, DE
About Henrietta Johnson Medical Center NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
HENRIETTA JOHNSON MEDICAL CENTER (NPI 1770699621) is a healthcare organization registered as a federally qualified health center (fqhc) in Wilmington, Delaware and active in the NPI registry since August 2006. The organization lists Rosa V Rivera, Chief Executive Officer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 4
Other Names 1
Other Identifiers 3
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Henrietta Johnson Medical Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
12Medicare enrollment records show 12 clinicians reassign Medicare billing to Henrietta Johnson Medical Center, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 9 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 4
Clinicians, nearest first (12)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Southbridge Medical Advisory Council Inc's NPI number?
The NPI number for Southbridge Medical Advisory Council Inc is 1770699621. It was assigned to this organization in the NPPES registry on August 22, 2006. The provider is doing business as Henrietta Johnson Medical Center.
Where is Southbridge Medical Advisory Council Inc located?
Southbridge Medical Advisory Council Inc is located at 601 New Castle Ave, Wilmington, DE 19801. The listed phone number is (302) 655-6187.
What is Southbridge Medical Advisory Council Inc's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.
Is Southbridge Medical Advisory Council Inc enrolled in Medicare?
Yes. Southbridge Medical Advisory Council Inc is registered in the Medicare PECOS enrollment system.
When is Southbridge Medical Advisory Council Inc's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Delaware, Clinic/Group Practice) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Southbridge Medical Advisory Council Inc?
According to the CMS Revalidation Reassignment List (October 2026 release), 12 clinicians in 4 Medicare specialties reassign their Medicare billing to Southbridge Medical Advisory Council Inc. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (8), Family Practice (2) and Clinical Social Worker (1). Of these, 4 practice at this address and 9 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Southbridge Medical Advisory Council Inc accept?
Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and AmeriHealth Caritas Next and 4 other insurers list Southbridge Medical Advisory Council Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Southbridge Medical Advisory Council Inc was last updated on January 16, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Henrietta Johnson Medical Center · NPI 1770699621
Federally Qualified Health Center (FQHC) organization in Wilmington, Delaware. Organization record, active in the CMS NPPES registry since August 22, 2006.
## Identity
- **NPI:** 1770699621 (Entity type: Organization)
- **Enumerated:** August 22, 2006
- **Primary specialty:** Clinic/Center - Federally Qualified Health Center (FQHC) · taxonomy 261QF0400X
- **Legal business name:** Southbridge Medical Advisory Council Inc
- **Organization subpart:** No
- **Authorized official:** Rosa Rivera, CHIEF EXECUTIVE OFFICER
## Practice location
- **Address:** 601 NEW CASTLE AVE, Wilmington, DE 19801
- **Phone:** (302) 655-6187 · **Fax:** (302) 655-6606
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 2027 (Non-DME Part B, Delaware, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 12 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (8), Family Practice (2), Clinical Social Worker (1); 4 practice at this address and 9 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 16, 2013
- **Other identifiers:** Medicare ID-Type Unspecified 081801; Medicaid 0000332866 (DE); Other 458117
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Source: [NPI Profile](https://npiprofile.com/npi/1770699621) · Data from the CMS NPPES public registry.