Douglas Heiner, MD

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

9250806-1205 Issued in UT

Practice address

9001 S 3200 W
West Jordan, UT 84088-9621

Phone

(801) 965-2799

NPI assigned

Jun 30, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in RI, AZ, UT3 enrollments

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.

Enrollment records 3

Specialty

Dermatology

Education

University of Texas Medical Branch at Galveston, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southwest Skin Specialists LLCGroup PAC ID 9739079864, 51 clinicians

Granger Medical Clinic PCGroup PAC ID 3476465691, 192 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Granger Medical Clinic PC

  • Multi-Specialty Clinic/Center
  • West Valley City, UT
  • NPI 1184657041
  Medicare reassignment Care Compare group NPD
• Southwest Skin Specialists LLC

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1174521926
  Medicare reassignment Care Compare group NPD
• Granger Medical Specialists LLC

  • Clinic/Center
  • West Valley City, UT
  • NPI 1376159368
  Medicare reassignment NPD
• Prospect Chartercare Physicians, LLC

  • Internal Medicine Physician
  • Cranston, RI
  • NPI 1629493135

  Dermatology

  Medicare reassignment NPD
• Granger Medical Clinic PC

  • Multi-Specialty Clinic/Center
  • Tooele, UT
  • NPI 1073811733
  NPD
• Granger Medical Clinic PC

  • Medical Specialty Clinic/Center
  • Sandy, UT
  • NPI 1871320028
  NPD
• Granger Medical Specialists, LLC

  • Multi-Specialty Clinic/Center
  • Salt Lake City, UT
  • NPI 1497441539
  NPD
• Southwest Skin Specialists, LLC

  • Clinical Medical Laboratory
  • Scottsdale, AZ
  • NPI 1609185347
  NPD
• Granger Medical Clinic PC

  • Multi-Specialty Clinic/Center
  • West Jordan, UT
  • NPI 1104857549
  NPD (past)

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1366753865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2965 W 3500 S",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841193602",
            "telephone_number": "801-965-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9001 S 3200 W",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840889621",
            "telephone_number": "801-965-2799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14155 N 83rd Ave Ste 110",
            "address_purpose": "LOCATION",
            "city": "Peoria",
            "state": "AZ",
            "postal_code": "853815640",
            "country_code": "US",
            "telephone_number": "623-215-0911 x214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEINER",
        "first_name": "DOUGLAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-30",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "UT",
            "license": "9250806-1205",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "RI",
            "license": "14668",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "AZ",
            "license": "50534",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "UT",
            "license": "9250806-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Makenna Heath
• Tiffany Hebert
• Olivia Hebertson
• Vineka Heeramun
• Andrew Brice Heinecke, FNP-C
• Courtney Heirtzler
• Helen L Stanhope Aprn LLC
• Hello ABA Ut LLC
• Yvette Henderson, RDN
• Clarissa Hendricks

• Procedural Dermatology Physician in West Jordan, UT
• Providers in West Jordan, UT by specialty
• Procedural Dermatology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.