Granger Medical Clinic PC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

GRANGER MEDICAL CLINIC PC

Practice address

9001 S 3200 W
West Jordan, UT 84088-9621

Phone

(801) 569-5520

NPI assigned

Jun 30, 2022

Last updated

Jun 30, 2022By 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

Mary Jane Pennington, MDNPI 1205868452

Title

President/Ceo

Phone

(801) 965-3600

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

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.

• Mary Jane Pennington, MD

  • Pediatrics Physician
  • West Valley City, UT
  • NPI 1205868452
  Authorized official Same address or phone

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

{
    "created_epoch": "1656547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656547200000",
    "number": "1871225441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7181 S CAMPUS VIEW DR STE 200",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840844312",
            "telephone_number": "801-965-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9001 S 3200 W",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840889621",
            "telephone_number": "801-569-5520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANGER MEDICAL CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-30",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-22",
        "status": "A",
        "authorized_official_last_name": "PENNINGTON",
        "authorized_official_first_name": "MARY JANE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "801-965-3600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Gorski Jr.
• Megan Gorton, DC
• Isaac Gottsch
• Bria Granados
• Granger Medical Clinic PC (Granger Medical West Jordan)
• Granger Medical Park City
• Granger Medical Sleep Clinic
• Granger Medical Specialists LLC
• Granger Medical West Jordan Sleep Center
• Alexis Grant

• Multi-Specialty Clinic/Center in West Jordan, UT
• Providers in West Jordan, UT by specialty
• Multi-Specialty Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.