Jordan Henderson, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

11443143-1205 Issued in UT

Practice address

30 N 1900 E RM 3C444
Salt Lake City, UT 84132-2501

Phone

(801) 581-3622

NPI assigned

Jun 13, 2014

Last updated

Nov 3, 2021By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT, SD, IL3 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

Anesthesiology

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Avera St LukesGroup PAC ID 6406764927, 164 clinicians

Associated Anesthesiologists SCGroup PAC ID 6305744129, 150 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Avera St Lukes Hospital, Aberdeen, SD, CCN 430014
• Saint Francis Medical Center Hospital, Peoria, IL, CCN 140067

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jhenderson368388@direct.med.utah.edu

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.

• Associated Anesthesiologists, S.C.

  • Anesthesiology Physician
  • Peoria, IL
  • NPI 1558306480
  Medicare reassignment Care Compare group NPD
• Avera St. Luke's

  dba Avera Internal Medicine Aberdeen

  • Internal Medicine Physician
  • Aberdeen, SD
  • NPI 1215100813
  Medicare reassignment Care Compare group NPD
• Millcreek Anesthesia PC

  • Anesthesiology Physician
  • Salt Lake City, UT
  • NPI 1306879820
  Medicare reassignment NPD
• University of Utah Adult Services

  • General Practice Physician
  • Salt Lake City, UT
  • NPI 1114321981
  Medicare reassignment NPD
• University of Utah Adult Services

  dba University of Utah Department of Ophthalmology

  • Ophthalmology Physician
  • Salt Lake City, UT
  • NPI 1326442179
  NPD
• University of Utah Adult Services

  dba University of Utah Hospital Radiology Department

  • Diagnostic Radiology Physician
  • Salt Lake City, UT
  • NPI 1598169419
  NPD
• Associated Anesthesiologists, SC

  • Anesthesiology Physician
  • Peoria, IL
  • NPI 1023612082
  NPD
• Avera St. Luke's

  • Hematology & Oncology Physician
  • Aberdeen, SD
  • NPI 1336483551
  NPD
• Avera St. Lukes

  dba Avera Medical Group Nephrology Aberdeen

  • Nephrology Physician
  • Aberdeen, SD
  • NPI 1477594430
  NPD

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

• Avera St Lukes

  • General Acute Care Hospital
  • Aberdeen, SD
  • NPI 1457309270
  Care Compare affiliation

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

{
    "created_epoch": "1402617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1710391107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N 1900 E RM 3C444",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841322501",
            "telephone_number": "801-581-3622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N 1900 E RM 3C444",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841322501",
            "telephone_number": "801-581-3622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "JORDAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-13",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "UT",
            "license": "11443143-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jhenderson368388@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "UNIVERSITY OF UTAH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amy Henderson, LCSW
• Annie Henderson
• Ashley Jan Henderson, LCSW
• Daniel Henderson, LCSW
• John Brandon Henderson
• Kara Henderson
• Michelle Reina Bosley Henderson, M.D.
• Mitchell Henderson
• Stewart John Henderson
• Garrett S Hendley

• Anesthesiology Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Anesthesiology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; 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.