Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jordan Henderson, MD

Individual provider Anesthesiology Physician · NPI 1710391107

Jordan Henderson, MD is an Anesthesiology in Salt Lake City, Utah. Qualified in 2020, 6 years ago. Practices with Avera St Lukes, a 166-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
6
Licensed in
UT
In the registry since
2014
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

30 N 1900 E Rm 3C444
Salt Lake City, UT 84132-2501
Phone: (801) 581-3622
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence 11443143-1205 (UT)

Record details

NPI number1710391107
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 13, 2014
Last updated in NPPESNovember 3, 2021
Certification dateNovember 3, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyANESTHESIOLOGY
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Avera St Lukes — 166 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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