Granger Medical Specialists, LLC
NPI 1497441539ActiveOrganization· Clinic/Center, Multi-Specialty· Salt Lake City, UT
Clinic/Center, Multi-Specialty in Salt Lake City, Utah, registered in NPPES in April 2023, part of Granger Medical Specialists, LLC. The authorized official on file is Mary Jane Pennington, MD, President/Ceo. Enrolled in Medicare as dme supplier - multi-specialty - physician.
Overview
| NPI | 1497441539 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Granger Medical Specialists, LLC |
| NPI issued | Apr 12, 2023 |
| Last updated in NPPES | Apr 12, 2023 |
| Certified by provider | Apr 12, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Clinic/Center, Multi-Specialty Primary | 261QM1300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Multi-Specialty - Physician (UT) |
|---|
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