GRANGER MEDICAL CLINIC PC
NPI 1184657041
Clinic/Center - Multi-Specialty in West Valley City, UT
About Granger Medical Clinic Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GRANGER MEDICAL CLINIC PC (NPI 1184657041) is a healthcare organization registered as a multi-specialty in West Valley City, Utah and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through October 11, 2027, maintains a secondary practice location in Riverton, and lists Mary Jane Pennington, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 12
Secondary Practice Location 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Granger Medical Clinic Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
190Medicare enrollment records show 190 clinicians reassign Medicare billing to Granger Medical Clinic PC, which bills Medicare for the services they deliver. Of these, 33 practice at this address and 127 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 32
Nearest to this location (20)
See all 190Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 46D1075091
Granger Medical Riverton · Riverton, UTFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Granger Medical Clinic PC's NPI number?
The NPI number for Granger Medical Clinic PC is 1184657041. It was assigned to this organization in the NPPES registry on July 7, 2006.
Where is Granger Medical Clinic PC located?
Granger Medical Clinic PC is located at 2965 W. 3500 S., West Valley City, UT 84119. The listed phone number is (801) 965-3600.
What is Granger Medical Clinic PC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.
Is Granger Medical Clinic PC enrolled in Medicare?
Yes. Granger Medical Clinic PC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Granger Medical Clinic PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 190 clinicians in 32 Medicare specialties reassign their Medicare billing to Granger Medical Clinic PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (38), Family Practice (34) and Urology (17). Of these, 33 practice at this address and 127 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Granger Medical Clinic PC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 46D1075091) is associated with this NPI, valid through October 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Granger Medical Clinic PC accept?
Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and BlueCross BlueShield of Tennessee and 4 other insurers list Granger Medical Clinic PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Granger Medical Clinic PC was last updated on December 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Granger Medical Clinic Pc · NPI 1184657041
Multi-Specialty organization in West Valley City, Utah. Organization record, active in the CMS NPPES registry since July 7, 2006.
## Identity
- **NPI:** 1184657041 (Entity type: Organization)
- **Enumerated:** July 7, 2006
- **Primary specialty:** Clinic/Center - Multi-Specialty · taxonomy 261QM1300X
- **Organization subpart:** No
- **Authorized official:** Mary Jane Pennington, PRESIDENT
## Practice location
- **Address:** 2965 W. 3500 S., West Valley City, UT 84119
- **Phone:** (801) 965-3600
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 190 clinicians in 32 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (38), Family Practice (34), Urology (17); 33 practice at this address and 127 within 10 miles; [full list](https://npiprofile.com/npi/1184657041/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 13, 2023
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1184657041) · Data from the CMS NPPES public registry.