Granite Peaks Endoscopy,LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

GRANITE PEAKS ENDOSCOPY,LLC

Practice address

10150 South Petunia Way
Sandy, UT 84092-4380

Phone

(801) 619-9000

Fax

(801) 619-9001

NPI assigned

Feb 19, 2007

Last updated

Jan 21, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Andrew Heiner, MDNPI 1497768014

Title

Medical Director

Phone

(801) 619-9000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Listed as

Granite Peaks Endoscopy LLCCCN 46C0001047

Medicare certification status

ActiveFrom the Provider of Services file

Locations

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Andrew M Heiner, M.D.

  • Gastroenterology Physician
  • Sandy, UT
  • NPI 1497768014
  Authorized official Same address or phone
• John David Schmidt, MD

  • Gastroenterology Physician
  • Sandy, UT
  • NPI 1972760106
  NPD
• Robert Kyle Barnett, M.D.

  • Gastroenterology Physician
  • Sandy, UT
  • NPI 1134119357
  NPD (past)
• Christopher Scott Cutler, MD

  • Gastroenterology Physician
  • Sandy, UT
  • NPI 1437162013
  NPD (past)
• Rachel Hansen, PA-C

  • Medical Physician Assistant
  • Lehi, UT
  • NPI 1932728813
  NPD (past)
• Mark Jensen, D.O.

  • Gastroenterology Physician
  • Sandy, UT
  • NPI 1912384389
  NPD (past)
• Scott Richard Moffitt, PA-C

  • Gastroenterology Physician
  • Sandy, UT
  • NPI 1881169043
  NPD (past)
• Marguerite King Marschner, PA-C

  • Physician Assistant
  • Marrero, LA
  • NPI 1295162444
  NPD (past)
• Michael John Weaver, MD

  • Gastroenterology Physician
  • Twin Falls, ID
  • NPI 1720427974
  NPD (past)

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611187200000",
    "number": "1083758320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10150 S PETUNIA WAY STE B",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840924328",
            "telephone_number": "801-619-9000",
            "fax_number": "801-619-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10150 SOUTH PETUNIA WAY",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840924380",
            "telephone_number": "801-619-9000",
            "fax_number": "801-619-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANITE PEAKS ENDOSCOPY,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A",
        "authorized_official_last_name": "HEINER",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "801-619-9000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grandpas Dental Care Inc.
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• Granger Medical Clinic PC
• Granger Medical Specialists LLC
• Granite Peaks Endoscopy Surgicenter LLC (Granite Peaks Endoscopy Center)
• Granite Peaks Gi, LLC
• Granite Peaks Pathology II LLC. (Granite Peaks Pathology)
• Granite Peaks Pathology P.C. (Granite Peaks Pathology)
• Granite Peaks Surgicenter, LLC (Granite Peaks Endoscopy Center)
• Brydon J.B. Grant, M.D.

• Ambulatory Surgical Clinic/Center in Sandy, UT
• Providers in Sandy, UT by specialty
• Ambulatory Surgical Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; 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.