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GRANGER MEDICAL SPECIALISTS LLC
NPI 1376159368
Clinic/Center in West Valley City, UT

Active since September 16, 2020
2965 W 3500 S, WEST VALLEY CITY, UT 84119(801) 965-3600 Get Directions Write a Review

NPPES record last updated: September 16, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Granger Medical Specialists Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRANGER MEDICAL SPECIALISTS LLC (NPI 1376159368) is a healthcare organization registered as a clinic/center in West Valley City, Utah and active in the NPI registry since September 2020. The organization lists Mary Jane Pennington, President/ceo, as its authorized official.

NPPES Registry Identity

NPI1376159368
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameGRANGER MEDICAL SPECIALISTS LLC
Location Address2965 W 3500 SWest Valley City, UT 84119-3602
Mailing Address7181 S Campus View Dr Ste 200West Jordan, UT 84084-4312 · (801) 965-3600
Phone(801) 965-3600
Organization SubpartNo
Authorized OfficialMary Jane PenningtonPresident/ceo · (801) 965-3600
Enumeration DateSeptember 16, 2020
NPPES CertifiedSeptember 16, 2020
✔ NPI 1376159368 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
2965 W 3500 S, West Valley City, UT 84119
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.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 Specialists Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

188

Medicare enrollment records show 188 clinicians reassign Medicare billing to Granger Medical Specialists LLC, which bills Medicare for the services they deliver. Of these, 33 practice at this address and 125 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 30

Nurse Practitioner38
Family Practice34
Urology17
Internal Medicine16
Obstetrics/Gynecology15
Pediatric Medicine9
Diagnostic Radiology7
Orthopedic Surgery6
22 other specialties46

Nearest to this location (20)

See all 188
Wayne Berg, FNP
Nurse Practitioner
NPI 1851813299
2965 W 3500 S
West Valley City, UT 84119
(801) 965-3600
✔ PECOS✔ Accepts MedicareSame address
William Burleigh, DPM
Podiatry
NPI 1023040276
2965 W 3500 S
West Valley City, UT 84119
(801) 965-3600
✔ PECOSSame address
Kathryn Casull, MD
Internal Medicine
NPI 1831256635
2965 W 3500 S
West Valley City, UT 84119
(801) 965-3419
✔ PECOS✔ Accepts MedicareSame address
Cheryle Cutlip, MD
Family Practice
NPI 1336171586
2965 W 3500 S
West Valley City, UT 84119
(801) 965-3600
✔ PECOS✔ Accepts MedicareSame address
Alyson Eyre, MD
Pediatric Medicine
NPI 1508897927
2965 W 3500 S
West Valley City, UT 84119
(801) 965-3600
✔ PECOSSame address
Andrew Fedoravicius, MD
Gastroenterology
NPI 1851585087
2965 W 3500 S
West Valley City, UT 84119
(801) 965-3600
✔ PECOS✔ Accepts MedicareSame address
Roy Gandolfi, MD
Internal Medicine
NPI 1740211101
2965 W 3500 S
West Valley City, UT 84119
(801) 965-3600
✔ PECOS✔ Accepts MedicareSame address
Terrell Glenn, MD
Family Practice
NPI 1972990174
2965 W 3500 S
West Valley City, UT 84119
(801) 965-3600
✔ PECOS✔ Accepts MedicareSame address
Gloria Gonzales, MD
Internal Medicine
NPI 1942235916
2965 W 3500 S
West Valley City, UT 84119
(801) 965-3600
✔ PECOS✔ Accepts MedicareSame address
Katherine Griffin, A.P.R.N.
Nurse Practitioner
NPI 1710912738
2965 W 3500 S
West Valley City, UT 84119
(801) 965-3600
✔ PECOSSame address
Kristen Gulock, NP
Nurse Practitioner
NPI 1033994470
2965 W 3500 S
West Valley City, UT 84119
(801) 965-3424
✔ PECOS✔ Accepts MedicareSame address
Casey Henich, MD
Family Practice
NPI 1003041740
2965 W 3500 S
West Valley City, UT 84119
(801) 965-3600
✔ PECOS✔ Accepts MedicareSame address
Michelle Looye, LCSW
Clinical Social Worker
NPI 1639554199
2965 W 3500 S
West Valley City, UT 84119
(801) 965-3600
✔ PECOSSame address
Mark Nevers, OD
Optometry
NPI 1366704959
2965 W 3500 S
West Valley City, UT 84119
(801) 965-3600
✔ PECOS✔ Accepts MedicareSame address
David Oelsner, M.D.
Gastroenterology
NPI 1396760765
2965 W 3500 S
West Valley City, UT 84119
(801) 965-3600
✔ PECOS✔ Accepts MedicareSame address
Mary Jane Pennington, MD
Pediatric Medicine
NPI 1205868452
2965 W 3500 S
West Valley City, UT 84119
(801) 965-3600
✔ PECOS✔ Accepts MedicareSame address
Komal Rastogi, MD
Neurology
NPI 1063774669
2965 W 3500 S
West Valley City, UT 84119
(801) 965-3600
✔ PECOS✔ Accepts MedicareSame address
Daniel Richards, DO
Orthopedic Surgery
NPI 1649455403
2965 W 3500 S
West Valley City, UT 84119
(801) 965-3600
✔ PECOS✔ Accepts MedicareSame address
Robert Smith, MD
Ophthalmology
NPI 1578675633
2965 W 3500 S
West Valley City, UT 84119
(801) 965-3600
✔ PECOS✔ Accepts MedicareSame address
Dean Walker, MD
Orthopedic Surgery
NPI 1861424012
2965 W 3500 S
West Valley City, UT 84119
(801) 965-3600
✔ PECOS✔ Accepts MedicareSame address
See all 188 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Specialists LLC's NPI number?

The NPI number for Granger Medical Specialists LLC is 1376159368. It was assigned to this organization in the NPPES registry on September 16, 2020.

Where is Granger Medical Specialists LLC located?

Granger Medical Specialists LLC is located at 2965 W 3500 S, West Valley City, UT 84119. The listed phone number is (801) 965-3600.

What is Granger Medical Specialists LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Is Granger Medical Specialists LLC enrolled in Medicare?

Yes. Granger Medical Specialists LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Granger Medical Specialists LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 188 clinicians in 30 Medicare specialties reassign their Medicare billing to Granger Medical Specialists LLC. 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 125 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Granger Medical Specialists LLC 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 BridgeSpan Health Company and 3 other insurers list Granger Medical Specialists LLC 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 Specialists LLC was last updated on September 16, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.