NPIMap

Individual provider Active NPI

Grant Henderson

  • Internal Medicine Physician
  • Stanford, CA
National Provider Identifier
1447592159
Registry record updated Jul 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A132955 Issued in CA
Practice address
300 Pasteur Dr
Lane 154
Stanford, CA 94305-2200
Phone
(650) 723-6661
Fax
(650) 498-6205
NPI assigned
Mar 20, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A132955 CA Primary

Addresses

Primary practice location

300 Pasteur Dr
Lane 154
Stanford, CA 94305-2200

Mailing address

300 Pasteur Dr
Lane 154
Stanford, CA 94305-2200
Phone (650) 723-6661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220912000158 CO Practitioner - Cardiovascular Disease (Cardiology) 2961795901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Columbia University College of Physicians and Surgeons, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Intermountain Medical Group Grand Junction, LLCGroup PAC ID 3779707856, 297 clinicians

Practice addresses (Care Compare)

1050 Wellington Ave
Imh Wellington Lung and Sleep Clinic
Grand Junction, CO 81501-8121
Phone (970) 298-5864

201 W Park Dr
201 West Park Cardiology
Grand Junction, CO 81505-1469
Phone (970) 298-3050

2635 N 7TH St
Grand Junction, CO 81501-8209

2686 Patterson Rd
Grand Junction, CO 81506-8817
Phone (970) 298-2001

360 W Park Dr
Intermountain Health Heart and Vascular Wes
Grand Junction, CO 81505-1448
Phone (970) 298-3050

Hospital & facility affiliations

  • Intermountain Health St. Mary'S Regional Hospital Hospital, Grand Junction, CO, CCN 060023
  • Montrose Regional Health Hospital, Montrose, CO, CCN 060006
  • Delta County Memorial Hospital Hospital, Delta, CO, CCN 060071
  • Family Health West Hospital Hospital, Fruita, CO, CCN 061302

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting42
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A132955CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Aug 1, 2022 Accepting new patients
Intermountain Medical Group Grand Junction, LLC Internal Medicine Current Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Aug 1, 2022 Accepting new patients
St. Mary'S Hospital and Medical Center, Inc. Past Accepting new patients
St Mary'S Hospital and Medical Center, Inc Internal Medicine Past Accepting new patients

Locations

500 Eldorado Blvd
Ste 4300
Broomfield, CO 80021

1050 Wellington Ave
Slp Ctr
Grand Junction, CO 81501
Phone (970) 298-5864

360 W Park Dr
#1
Grand Junction, CO 81505

360 W Park Dr
Grand Junction, CO 81505
Phone (970) 244-2482

1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1363737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467676800000",
    "number": "1447592159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "address_2": "LANE 154",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-6661",
            "fax_number": "650-498-6205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "address_2": "LANE 154",
            "city": "STANFORD",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-723-6661",
            "fax_number": "650-498-6205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "GRANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-20",
        "last_updated": "2016-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A132955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stanford, CA

Sources for this page

Verify at the official NPI Registry.