David J Henderson, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

1593801205 Issued in UT

Practice address

440 Medical Dr Ste 3
Bountiful, UT 84010-5174

Phone

(385) 722-9566

Fax

(385) 722-9567

NPI assigned

Dec 22, 2005

Last updated

Jan 17, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in UT

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 1

Specialty

Urology

Education

University of Utah School of Medicine, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lakeview Hospital Hospital, Bountiful, UT, CCN 460042

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bountifulurology.davidhenderson@160876.advancedmd-direct.com
• Direct secure messaging: david.henderson@hca3.eclinicaldirectplus.com

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

• David J Henderson M D a Professional Corporation

  • Specialist
  • Bountiful, UT
  • NPI 1760512578
  Medicare reassignment NPD Authorized official
• Scott a Erickson MD, PC

  • Family Medicine Physician
  • Bountiful, UT
  • NPI 1972500882

  Urology

  Medicare reassignment NPD
• David J Henderson M D a Professional Corporation

  dba Bountiful Urology

  • Urology Physician
  • Bountiful, UT
  • NPI 1730990722
  NPD (past) Authorized official

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hospital Corporation of Utah

  dba Lakeview Hospital

  • General Acute Care Hospital
  • Bountiful, UT
  • NPI 1528010451
  Care Compare affiliation

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1417933284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 S MAIN ST",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840106236",
            "telephone_number": "801-505-0821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 MEDICAL DR STE 3",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840105174",
            "telephone_number": "385-722-9566",
            "fax_number": "385-722-9567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "UT",
            "license": "1593801205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05356",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518109032",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jared Heaton, D.O.
• Erin Heckaman, MS, LCGC
• Carrie L Hedberg
• Holly Lynn Hele
• Elise Ann Hemmingsen
• Jeffrey Lynn Henderson, MD
• Nedda Beth Hendler, MD
• Travis M Hendry, MD
• Taylor Dawn Heninger
• Kara A. Henrie

• Urology Physician in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Urology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.