Individual provider Active NPI

Melinda B Henne, MD

  • Reproductive Endocrinology Physician
  • Pleasant Grove, UT
National Provider Identifier
1255438636
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
14205993-1235 Issued in UT
Practice address
1446 W Pleasant Grove Blvd
Pleasant Grove, UT 84062-3216
Phone
(801) 785-5100
Fax
(801) 785-4597
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology Physician 207VE0102X ME131549 FL
Reproductive Endocrinology Physician 207VE0102X 14205993-1235 UT Primary

Addresses

Primary practice location

1446 W Pleasant Grove Blvd
Pleasant Grove, UT 84062-3216

Mailing address

1446 W Pleasant Grove Blvd
Pleasant Grove, UT 84062-3216
Phone (801) 785-5100

Other practice location 1

535 W Sunnyside Rd Ste 1
Idaho Falls, ID 83402-4647
Phone (208) 529-2019

Other identifiers 2

IdentifierTypeStateIssuer
020761500MedicaidFL
K0UWUOtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Apr 1, 2019 through Apr 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME131549FLMDReproductive Endocrinology Physician
14205993-1235UTMDReproductive Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Center for Reproductive Medicine Reproductive Endocrinology Past Accepting new patients
Reproductive Medicine Associates, P.a. Reproductive Endocrinology Past Accepting new patients
Bronson Lakeview Hospital PastSince Feb 23, 2025 Accepting new patients
Utah Fertility Center PastSince Feb 23, 2025 Accepting new patients
North Florida Reproductive Medicine, LLC Reproductive Endocrinology Past Accepting new patients

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739923200000",
    "number": "1255438636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1446 W PLEASANT GROVE BLVD",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840623216",
            "telephone_number": "801-785-5100",
            "fax_number": "801-785-4597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1446 W PLEASANT GROVE BLVD",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840623216",
            "telephone_number": "801-785-5100",
            "fax_number": "801-785-4597"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "535 W Sunnyside Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Idaho Falls",
            "state": "ID",
            "postal_code": "834024647",
            "country_code": "US",
            "telephone_number": "208-529-2019",
            "fax_number": "801-785-4597",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENNE",
        "first_name": "MELINDA",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "FL",
            "license": "ME131549",
            "primary": false
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "UT",
            "license": "14205993-1235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020761500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "K0UWU",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Grove, UT

Sources for this page

Verify at the official NPI Registry.