Stephanie Diane Henderson, MD
Individual provider Active NPI Obstetrics & Gynecology Physician · Sandy, UT
NPI 1982997284 · NPPES record last updated Dec 12, 2023
Key facts
- NPI
- 1982997284
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 10259776-1205 (UT)
- Practice address
- 9450 S 1300 E
Sandy, UT 84094-5555 - Phone
- (801) 501-2160
- Fax
- (801) 501-2107
- NPI assigned
- May 18, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Gynecological Oncology
- Education
- University of Rochester School of Medicine and Dentistry, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- San Juan County Hospital
Ihc Health Services Inc
Practice addresses (Care Compare)
380 W 100
Monticello, UT 84535-0308
Phone (435) 587-2116
380 W 100
Suite a
Monticello, UT 84535-7879
Phone (435) 587-5054
9450 S 1300
Sandy, UT 84094-5555
Phone (801) 501-6250
PO Box
Suite 1054
Monticello, UT 84535
Hospital & facility affiliations
- Intermountain Health Alta View Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of the uterus | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170706001586 | UT | Practitioner - Gynecological Oncology | 5991074940 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R72652 | AZ | MD | Obstetrics & Gynecology Physician |
| 10259776-1205 | UT | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Juan County Hospital | Current |
Accepting new patients | |
| San Juan County Hospital | Current | Accepting new patients | |
| Granger Medical Clinic, Inc. | Current |
Accepting new patients | |
| San Juan County Hospital | Current |
Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services Inc | Current |
Accepting new patients | |
| San Juan County Hospital | Current |
Accepting new patients | |
| Granger Medical Clinic PC | Obstetrics & Gynecology | Current | Accepting new patients |
| Ihc Health Services, Inc. | Current |
Accepting new patients |
Locations
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
12391 S 4000 W
Riverton, UT 84096
Phone (801) 302-1700
9450 S 1300 E
Sandy, UT 84094
Phone (801) 501-2133
7181 S Campus View Dr
Ste 200
West Jordan, UT 84084
Phone (801) 965-3505
7181 S Campus View Dr
West Jordan, UT 84084
Phone (801) 965-3505
3725 W 4100 S
West Valley City, UT 84120
Phone (801) 965-3545
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/d2bc3d5a-3c39-4553-86b1-b3aa0a5429a7/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | R72652 | AZ | |
| Obstetrics & Gynecology Physician | 207V00000X | 10259776-1205 | UT | Yes |
Addresses
Primary practice location
9450 S 1300 E
Sandy, UT 84094-5555
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Other practice location 1
348 E 4500 S Ste 200
Salt Lake City, UT 84107
Phone (801) 965-3600
Other practice location 2
1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone (602) 839-4344
Other practice location 3
1111 E McDowell Rd
Phoenix, AZ 85006-2612
Phone (602) 839-4344
Other providers in Sandy, UT
- Andrew M Heiner
- Katherine Heller
- Peggy J Helms
- Helperly Corporation
- Helping Hands Counseling, LLC
- Angie Suzanne Hendren
- Jacob Thomas Hendricks
- Brooke Dianne Hendrickson
- Kami Westbroek Hendry
- Carla B. Henkel
All providers in Sandy, UT · Obstetrics & Gynecology Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 12, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.