Individual provider Active NPI

David Reeves Henly, M.D.

  • Urology Physician
  • Stillwater, MN
National Provider Identifier
1962481812
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
32643 Issued in MN
Practice address
1500 Curve Crest Blvd W
Stillwater, MN 55082-6040
Phone
(651) 439-1234
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 32643 MN Primary

Addresses

Primary practice location

1500 Curve Crest Blvd W
Stillwater, MN 55082-6040

Mailing address

8170 33Rd Ave S # Ms 21110Q
Minneapolis, MN 55425-4516

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20060202000841 WI Practitioner - Urology 6204840887 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Mayo Medical School, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Burnett Medical Center IncGroup PAC ID 2163314931, shared by 4 NPIs, 20 clinicians

Practice addresses (Care Compare)

257 W Saint George Ave
Grantburg, WI 54840-7827
Phone (715) 463-5353

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Burnett Medical Center Inc CurrentSince Sep 18, 2025 Accepting new patients
Burnett Medical Center Inc Current Accepting new patients
Group Health, Inc. CurrentSince Jan 1, 2016 Accepting new patients
Burnett Medical Center Inc CurrentSince Sep 18, 2025 Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince May 16, 2016 Accepting new patients
Amery Regional Medical Center, Inc. CurrentSince May 16, 2016 Accepting new patients

Locations

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

265 Griffin St E
Amery, WI 54001
Phone (715) 268-0301

257 W Saint George Ave
Grantsburg, WI 54840
Phone (715) 463-5353

411 Stageline Rd
#200
Hudson, WI 54016
Phone (715) 531-6700

535 Hospital Rd
New Richmond, WI 54017
Phone (651) 292-2013

Organizations & group practices 7

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 1

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": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1962481812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 CURVE CREST BLVD W",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826040",
            "telephone_number": "651-439-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENLY",
        "first_name": "DAVID",
        "middle_name": "REEVES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MN",
            "license": "32643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, MN

Sources for this page

Verify at the official NPI Registry.