Tegan Grunwald

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

12627832-4405 Issued in UT

Practice address

3115 E Lion LN Ste 160
Salt Lake City, UT 84121

Phone

(855) 255-1750

Fax

(855) 255-0905

NPI assigned

Mar 1, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

United Wound Healing PSGroup PAC ID 2860794070, 32 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• United Wound Healing PS

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Puyallup, WA
  • NPI 1669845327

  UT

  Medicare reassignment Care Compare group NPD
• United Wound Healing Accountable Care Consultants PLLC

  • Surgery Physician
  • Puyallup, WA
  • NPI 1881337632

  Family

  NPD (past)

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

{
    "created_epoch": "1740787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1386441996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2177 S NOWELL CIR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841152869",
            "telephone_number": "541-760-0032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 E LION LN STE 160",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84121",
            "telephone_number": "855-255-1750",
            "fax_number": "855-255-0905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2177 S Nowell Cir",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841152869",
            "country_code": "US",
            "telephone_number": "541-760-0032",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRUNWALD",
        "first_name": "TEGAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-01",
        "last_updated": "2025-09-11",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "12627832-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shalee Grover
• Kristina Groves, LCSW
• Brandan Grovier
• Joanna Grudziak, MD, MPH
• Jessica Laurine Grundie
• Joel Grussendorf, PHARMD
• Lauren Gryczkowski
• Helena Moore Gryzenia
• Gsded, LLC
• Mingyu Gu, DNP

• Family Nurse Practitioner in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.