Individual provider Active NPI

Trent C Henderson, P.T.

  • Physical Therapist
  • Kaysville, UT
National Provider Identifier
1770892366
Registry record updated Aug 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7759519-2401 Issued in UT
Practice address
335 N 300 W Ste 103
Kaysville, UT 84037-1815
Phone
(801) 546-6868
Fax
(801) 546-8225
NPI assigned
Sep 29, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 7759519-2401 UT Primary

Addresses

Primary practice location

335 N 300 W Ste 103
Kaysville, UT 84037-1815

Mailing address

335 N 300 W Ste 103
Kaysville, UT 84037-1815
Phone (801) 546-6868

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110126001155 UT Practitioner - Physical Therapist in Private Practice 9830378504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fit Quest Therapy and Rehabilitation Clinic LLCGroup PAC ID 8224197819, 4 clinicians

Practice addresses (Care Compare)

335 N 300
Suite 103
Kaysville, UT 84037-1815
Phone (801) 546-6868

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7759519-2401UTMDPhysical Therapist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1770892366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 N 300 W STE 103",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840371815",
            "telephone_number": "801-546-6868",
            "fax_number": "801-546-8225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 N 300 W STE 103",
            "city": "KAYSVILLE",
            "state": "UT",
            "postal_code": "840371815",
            "telephone_number": "801-546-6868",
            "fax_number": "801-546-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "TRENT",
        "middle_name": "C",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-29",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "7759519-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kaysville, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.