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GRANGER MEDICAL CLINIC - WASATCH
NPI 1629163746
Internal Medicine in Salt Lake City, UT

Active since October 04, 2006CLIA Certified · 2 labs
1160 E 3900 S, SUITE 1000, SALT LAKE CITY, UT 84124(801) 262-1771(801) 288-9101 Get Directions Write a Review

NPPES record last updated: August 16, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Granger Medical Clinic - Wasatch NPPES

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

GRANGER MEDICAL CLINIC - WASATCH (NPI 1629163746) is a healthcare organization registered as an internal medicine in Salt Lake City, Utah and active in the NPI registry since October 2006. The organization holds 2 active CLIA laboratory certificates and lists Anne M Whitaker, Credentialing Coordinator, as its authorized official.

NPPES Registry Identity

NPI1629163746
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameGRANGER MEDICAL CLINIC, INC.
Location Address1160 E 3900 S, SUITE 1000Salt Lake City, UT 84124-1202
Mailing Address1160 E 3900 S, Suite 1000Salt Lake City, UT 84124-1202 · (801) 262-1771 · Fax (801) 288-9101
Phone(801) 262-1771
Fax(801) 288-9101
Organization SubpartYes
Authorized OfficialAnne M WhitakerCredentialing Coordinator · (801) 965-3505
Enumeration DateOctober 4, 2006
Last NPPES UpdateAugust 16, 2016
✔ NPI 1629163746 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in UT · 870526286
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1160 E 3900 S, Salt Lake City, UT 84124
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Other Names 1

Doing Business AsGranger Medical Clinic - Wasatch

Other Identifiers 3

Medicare PIN000055217UT
Medicare PIN000004880UT
Other870526286UT · Ein

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

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 Accreditation 46D1027928

Granger Medical Clinic / Lab · Salt Lake City, UT
Active · expires Feb 5, 2027
CLIA Number46D1027928
Laboratory TypePhysician Office
Certificate Effective DateFebruary 6, 2025
Certificate Expiration DateFebruary 5, 2027
Laboratory DirectorDr. Brian Kelly
Laboratory Phone(801) 965-3482
Laboratory LocationGranger Medical Clinic / Lab995 W Levoy Dr, Salt Lake City, UT 84123
CLIA data matches this NPI record on: Name
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Waiver 46D2316503

Granger Medical Clinic Pain And Spine Cottonwood Heights · Salt Lake City, UT
Active · expires Jan 6, 2027
CLIA Number46D2316503
Laboratory TypePhysician Office
Certificate Effective DateJanuary 7, 2025
Certificate Expiration DateJanuary 6, 2027
Laboratory DirectorGeeta Nagpal
Laboratory Phone(801) 569-5547
Laboratory LocationGranger Medical Clinic Pain And Spine Cottonwood Heights6322 S 3000 E, Ste 100, Salt Lake City, UT 84121
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAMES S ZEBRACK MD
Internal Medicine (Cardiovascular Disease)
1160 E 3900 S, STE 2000
SALT LAKE CITY, UT 84124
Salt Lake County (801) 266-3418
DR. KELLY RAMSAY O'NEAL III MD, MS
Internal Medicine (Cardiovascular Disease)
1160 E 3900 S, SUITE 2000
SALT LAKE CITY, UT 84124
Salt Lake County (801) 266-3418
DR. JEFFREY G RANDLE MD
Physical Medicine & Rehabilitation
1160 E 3900 S, #5000
SALT LAKE CITY, UT 84124
Salt Lake County (801) 262-8486
KENNETH G NIELSON MD
Internal Medicine (Cardiovascular Disease)
1160 E 3900 S, STE 2000
SALT LAKE CITY, UT 84124
Salt Lake County (801) 266-3418
DR. MINA GOHARI M.D.
Family Medicine
1160 E 3900 S, STE G200
SALT LAKE CITY, UT 84124
Salt Lake County (801) 268-7766
JAMES JOSEPH CHAMBERLAIN MD
Internal Medicine
1160 E 3900 S, SUITE 1200
SALT LAKE CITY, UT 84124
Salt Lake County (801) 261-9651
PAWAN K SHARMA MD
Nuclear Medicine (Nuclear Cardiology)
1160 E 3900 S, STE 2000
SALT LAKE CITY, UT 84124
Salt Lake County (801) 266-3418
STEPHEN G ROPER PA
Physician Assistant
1160 E 3900 S, #5000
SALT LAKE CITY, UT 84124
Salt Lake County (801) 262-8486

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, Inc.'s NPI number?

The NPI number for Granger Medical Clinic, Inc. is 1629163746. It was assigned to this organization in the NPPES registry on October 4, 2006. The provider is doing business as Granger Medical Clinic - Wasatch.

Where is Granger Medical Clinic, Inc. located?

Granger Medical Clinic, Inc. is located at 1160 E 3900 S Suite 1000, Salt Lake City, UT 84124. The listed phone number is (801) 262-1771.

What is Granger Medical Clinic, Inc.'s specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Granger Medical Clinic, Inc. hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Granger Medical Clinic, Inc. was last updated on August 16, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.