Individual provider Active NPI

Jennifer Lynne Glazier, PA-C

  • Medical Physician Assistant
  • Riverton, UT
National Provider Identifier
1255771499
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
8708402-1206 Issued in UT
Practice address
12391 S 4000 W
Riverton, UT 84096-7012
Phone
(801) 302-1700
NPI assigned
Jul 2, 2013
Last updated
Jan 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 8708402-1206 UT
Medical Physician Assistant 363AM0700X 8708402-1206 UT Primary

Addresses

Primary practice location

12391 S 4000 W
Riverton, UT 84096-7012

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130815000724 UT Practitioner - Physician Assistant 9830331107 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Granger Medical Clinic PCGroup PAC ID 3476465691, 192 clinicians
South Valley Women's Health Care PCGroup PAC ID 7810927241, 10 clinicians

Practice addresses (Care Compare)

12391 S 4000
Riverton, UT 84096-7012
Phone (801) 302-1700

13825 S Redwood Rd
Suite 200
Bluffdale, UT 84065-5255
Phone (801) 569-2626

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Granger Medical Specialists LLC CurrentSince Jan 5, 2026 Accepting new patients
Granger Medical Clinic, PC CurrentSince Jan 5, 2026 Accepting new patients
Granger Medical Specialists, LLC CurrentSince Jan 5, 2026 Accepting new patients
Granger Medical Clinic PC CurrentSince Jan 5, 2026 Accepting new patients
Granger Medical Clinic PC Past Accepting new patients
Granger Medical Clinic PC Past Accepting new patients
South Valley Women's Imaging, LLC Past Accepting new patients

Locations

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

995 W Levoy Dr
Taylorsville, UT 84123

3181 W 9000 S
West Jordan, UT 84088
Phone (801) 352-5900

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

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1372723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1255771499",
    "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": "12391 S 4000 W",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840967012",
            "telephone_number": "801-302-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLAZIER",
        "first_name": "JENNIFER",
        "middle_name": "LYNNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-02",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "8708402-1206",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "8708402-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverton, UT

Sources for this page

Verify at the official NPI Registry.