GRANGER MEDICAL CLINIC PC - NPI 1184657041 - Clinic/Center in West Valley City, UT

Q: 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.

Q: 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.

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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

NPI1184657041

Entity TypeOrganization

Primary Taxonomy261QM1300X

Legal Business NameGRANGER MEDICAL CLINIC PC

Location Address2965 W. 3500 S.West Valley City, UT 84119

Mailing Address2965 W 3500 SWest Valley City, UT 84119-3602 · (801) 965-3600

Phone(801) 965-3600

Organization SubpartNo

Authorized OfficialMary Jane PenningtonPresident · (801) 965-3417

Enumeration DateJuly 7, 2006

Last NPPES UpdateDecember 13, 20234 updates tracked since enumeration

NPPES CertifiedDecember 13, 2023

✔ NPI 1184657041 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 12

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities

Taxonomy Code261QM1300X

Also ListedFamily MedicineTaxonomy 207Q00000X

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedInternal Medicine · GastroenterologyTaxonomy 207RG0100X

Also ListedObstetrics & GynecologyTaxonomy 207V00000X

Also ListedOrthopaedic SurgeryTaxonomy 207X00000X

Also ListedOtolaryngologyTaxonomy 207Y00000X

Also ListedPediatricsTaxonomy 208000000X

Also ListedPhysical Medicine & RehabilitationTaxonomy 208100000X

Also ListedPlastic Surgery · Surgery of the HandTaxonomy 2082S0105X

Also ListedPsychiatry & Neurology · NeurologyTaxonomy 2084N0400X

Also ListedSurgeryTaxonomy 208600000X

2965 W. 3500 S., West Valley City, UT 84119

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Secondary Practice Location 1

Location 112391 S 4000 WRiverton, UT 84096-7012 · Phone (801) 302-1700

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee, BridgeSpan Health Company, Molina Healthcare and more.Insurance ›

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, UT

Active · expires Oct 11, 2027

CLIA Number46D1075091

Laboratory TypePhysician Office

Certificate Effective DateOctober 12, 2025

Certificate Expiration DateOctober 11, 2027

Laboratory DirectorStephen B. Devenport, MD

Laboratory Phone(801) 302-1700

Laboratory LocationGranger Medical Riverton12391 S 4000 W, Ste 100, Riverton, UT 84096

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently 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.

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 BlueCross BlueShield of Tennessee, BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and University of Utah Health Plans 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 with the weekly NPPES data releases published by CMS.