Individual provider Active NPI

Eric R. Grover, DO

  • Family Medicine Physician
  • West Jordan, UT
National Provider Identifier
1174801179
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11353427-1204 Issued in UT
Practice address
3181 W 9000 S
West Jordan, UT 84088-5610
Phone
(801) 352-5900
Fax
(801) 352-5914
NPI assigned
Jul 26, 2011
Last updated
Dec 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A13265 CA
Family Medicine Physician 207Q00000X 11353427-1204 UT Primary

Addresses

Primary practice location

3181 W 9000 S
West Jordan, UT 84088-5610

Mailing address

2965 W 3500 S
West Valley City, UT 84119-3602
Phone (801) 965-3600

Other practice location 1

4190 Chicago Ave
Riverside, CA 92507-5348
Phone (951) 683-2106

Other practice location 2

1688 N Perris Blvd Ste H4
Perris, CA 92571-4746
Phone (951) 657-7876

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, UT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20141206000004 CA Practitioner - Family Practice 3375865199 Reassigns benefits to 1 organization
I20201103001215 UT Practitioner - Family Practice 3375865199 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Granger Medical Clinic PCGroup PAC ID 3476465691, 192 clinicians
Mommy and Me Medical Group IncGroup PAC ID 0244383727, 6 clinicians

Practice addresses (Care Compare)

2965 W 3500
West Valley City, UT 84119-3602
Phone (801) 965-3600

4190 Chicago Ave
Riverside, CA 92507-5348
Phone (951) 683-2106

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A13265CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Granger Medical Clinic PC Family Medicine Current Accepting new patients
Granger Medical Specialists LLC CurrentSince Oct 10, 2023 Accepting new patients
Granger Medical Specialists, LLC CurrentSince Oct 10, 2023 Accepting new patients
Mommy and Me Medical Group, Inc. Family Medicine CurrentSince Jul 1, 2020 Accepting new patients
Granger Medical Clinic PC Past Accepting new patients
Reuben C Castillo, Professional Corporation Past Accepting new patients

Locations

1688 N Perris Blvd
Ste H4
Perris, CA 92571
Phone (951) 647-7876

498 W 4th St
Perris, CA 92570
Phone (951) 657-5441

4190 Chicago Ave
Riverside, CA 92507
Phone (951) 632-2106

12391 S 4000 W
Riverton, UT 84096
Phone (801) 302-1700

995 W Levoy Dr
Taylorsville, UT 84123

7181 S Campus View Dr
West Jordan, UT 84084
Phone (801) 965-3505

2965 W 3500 S
West Valley City, UT 84119
Phone (801) 965-3505

3725 W 4100 S
West Valley City, UT 84120
Phone (801) 965-3545

Networks

  • UT PPO D-SNP
  • UT PPO
  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: eric.grover.p1@direct.chsica.nextgenshare.com
  • Direct secure messaging: eric.grover.p2@direct.mpmccorp.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1311638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1174801179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2965 W 3500 S",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841193602",
            "telephone_number": "801-965-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3181 W 9000 S",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840885610",
            "telephone_number": "801-352-5900",
            "fax_number": "801-352-5914"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4190 Chicago Ave",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925075348",
            "country_code": "US",
            "telephone_number": "951-683-2106",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1688 N Perris Blvd Ste H4",
            "address_purpose": "LOCATION",
            "city": "Perris",
            "state": "CA",
            "postal_code": "925714746",
            "country_code": "US",
            "telephone_number": "951-657-7876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROVER",
        "first_name": "ERIC",
        "middle_name": "R.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-26",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A13265",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "11353427-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Jordan, UT

Sources for this page

Verify at the official NPI Registry.