Jeffrey Lynn Henderson, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

8294005-1205 Issued in UT

Practice address

390 N Main St
Bountiful, UT 84010-6046

Phone

(801) 292-6100

NPI assigned

May 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in UT, NV2 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 2

Specialty

Emergency Medicine

Education

University of Texas Medical School at Houston, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Irv Edwards MD PCGroup PAC ID 2365926698, 33 clinicians

Ihc Health Services IncGroup PAC ID 1850209420, shared by 68 NPIs, 3,948 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Park City Hospital Hospital, Park City, UT, CCN 460057
• Henderson Hospital Hospital, Henderson, NV, CCN 290057
• Intermountain Health Heber Valley Hospital Hospital, Heber City, UT, CCN 461307

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Irv Edwards MD PC

  • Emergency Medicine Physician
  • Henderson, NV
  • NPI 1013884352
  Medicare reassignment Care Compare group
• Ihc Health Services Inc

  • Critical Access Hospital
  • Heber City, UT
  • NPI 1316055205
  Medicare reassignment NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Murray, UT
  • NPI 1629260880
  Medicare reassignment NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment NPD
• Shadow Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Las Vegas, NV
  • NPI 1184795874
  Medicare reassignment NPD
• Ihc Health Services Inc

  • Obstetrics & Gynecology Physician
  • Provo, UT
  • NPI 1114191517
  NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • American Fork, UT
  • NPI 1669420014
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Shadow Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Las Vegas, NV
  • NPI 1043030919
  NPD
• Ascension Seton

  • Family Medicine Physician
  • Luling, TX
  • NPI 1215118609
  NPD (past)

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

• Ihc Health Services Inc

  • Critical Access Hospital
  • Heber City, UT
  • NPI 1316055205
  Care Compare affiliation
• Ihc Health Services Inc

  • General Acute Care Hospital
  • Park City, UT
  • NPI 1851530984
  Care Compare affiliation
• Henderson Hospital

  • General Acute Care Hospital
  • Henderson, NV
  • NPI 1003281452
  Care Compare affiliation
• Henderson Hospital

  • Emergency Care Clinic/Center
  • Henderson, NV
  • NPI 1285490292

  Hospital

  Care Compare affiliation
• Henderson Hospital

  • Emergency Care Clinic/Center
  • Henderson, NV
  • NPI 1376198028

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492646400000",
    "number": "1528026978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-292-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 N MAIN ST",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840106046",
            "telephone_number": "801-292-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "JEFFREY",
        "middle_name": "LYNN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2017-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "M4145",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "UT",
            "license": "8294005-1205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8V1546",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN",
            "identifier": "181360202",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "181360201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin Heckaman, MS, LCGC
• Carrie L Hedberg
• Holly Lynn Hele
• Elise Ann Hemmingsen
• David J Henderson, MD
• Nedda Beth Hendler, MD
• Travis M Hendry, MD
• Taylor Dawn Heninger
• Kara A. Henrie
• Brandon Henshaw

• Emergency Medicine Physician in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Emergency Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; 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.