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DAVID J HENDERSON M D A PROFESSIONAL CORPORATION
NPI 1760512578
Specialist in Bountiful, UT

Active since March 07, 2007
415 MEDICAL DR, 202 A, BOUNTIFUL, UT 84010(801) 298-3247(801) 298-9675 Get Directions Write a Review

NPPES record last updated: April 30, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About David J Henderson M D A Professional Corporation NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DAVID J HENDERSON M D A PROFESSIONAL CORPORATION (NPI 1760512578) is a healthcare organization registered as a specialist in Bountiful, Utah and active in the NPI registry since March 2007. The organization lists David J Henderson, President, as its authorized official.

NPPES Registry Identity

NPI1760512578
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameDAVID J HENDERSON M D A PROFESSIONAL CORPORATION
Location Address415 MEDICAL DR, 202 ABountiful, UT 84010-4946
Mailing Address415 Medical DrBountiful, UT 84010-4946 · (801) 298-3247 · Fax (801) 298-9675
Phone(801) 298-3247
Fax(801) 298-9675
Organization SubpartNo
Authorized OfficialDavid J HendersonPresident · (801) 298-3247
Enumeration DateMarch 7, 2007
Last NPPES UpdateApril 30, 2025
NPPES CertifiedApril 30, 2025
✔ NPI 1760512578 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in UT · 1593808905
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
415 MEDICAL DR, Bountiful, UT 84010
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

David J Henderson M D A Professional Corporation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to David J Henderson M D A Professional Corporation, which bills Medicare for the services this clinician delivers.

Clinician (1)

David Henderson, MD
Urology
NPI 1417933284
440 MEDICAL DR STE 3
Bountiful, UT 84010
(385) 722-9566
✔ PECOS✔ Accepts Medicare0.1 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is David J Henderson M D A Professional Corporation's NPI number?

The NPI number for David J Henderson M D A Professional Corporation is 1760512578. It was assigned to this organization in the NPPES registry on March 7, 2007.

Where is David J Henderson M D A Professional Corporation located?

David J Henderson M D A Professional Corporation is located at 415 Medical Dr 202 A, Bountiful, UT 84010. The listed phone number is (801) 298-3247.

What is David J Henderson M D A Professional Corporation's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is David J Henderson M D A Professional Corporation enrolled in Medicare?

Yes. David J Henderson M D A Professional Corporation is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through David J Henderson M D A Professional Corporation?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Urology) reassigns their Medicare billing to David J Henderson M D A Professional Corporation. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for David J Henderson M D A Professional Corporation was last updated on April 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.