Granger Medical Park City
NPI 1699050823ActiveOrganization· Clinic/Center, Multi-Specialty· West Jordan, UT
Clinic/Center, Multi-Specialty in West Jordan, Utah, registered in NPPES in October 2011, part of Granger Medical Clinic Inc. The authorized official on file is Mary Jane Pennington, MD, President.
Overview
| NPI | 1699050823 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Granger Medical Clinic Inc |
| NPI issued | Oct 19, 2011 |
| Last updated in NPPES | May 13, 2013 |
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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Clinic/Center, Multi-Specialty providers in West Jordan
- 1104857549
- 1205187325
- 1326789090
- 1689454050
- 1871225441