GRANGER MEDICAL TOOELE (NPI# 1073811733) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073811733 |
| Entity Type | Organization |
| Organization Name | GRANGER MEDICAL TOOELE |
| Practice Address |
2356 N 400 E Ste 201 Tooele UT 84074-3409 |
| Practice Telephone | 8013525900 |
| Practice Fax Number | 8013525914 |
| Mailing Telephone | 8013525900 |
| Mailing Fax Number | 8013525914 |
| Enumeration Date | 2011-03-04 |
| Last Update Date | 2013-05-13 |
| Authorized Official Name | MRS. MARGARET A ZDUNICH (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 8019653682 |
| Is Organization Subpart | Y |
| Parent Organization Name | GRANGER MEDICAL CLINIC INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Street Address |
2356 N 400 E STE 201 |
| City | TOOELE |
| State | UT |
| Zip Code | 84074-3409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720632078 | Amanda L Sheffer | Nurse Practitioner | 2356 N 400 E Ste 201, Tooele, UT 84074-3409 | 2019-07-25 |
| 1912338872 | Lori C Hamilton | Physician Assistant | 2356 N 400 E Ste 201, Tooele, UT 84074-3409 | 2013-12-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689233397 | Leah Elizabeth Harper I | Behavior Technician | 39 Millpond Stansbury Park, Tooele, UT 84074 | 2019-06-07 |
| 1245710789 | Tanna Marie Shelley | Community Health Worker | 27 So Main St, Tooele, UT 84074 | 2018-08-15 |
| 1528548062 | Barbara T Cederlof | Community Health Worker | 27 South Main St., Tooele, UT 84074 | 2018-08-15 |
| 1235615600 | Ashley Christine Wilson | Case Manager/Care Coordinator | 27 South Main, Tooele, UT 84074 | 2018-07-18 |
| 1174016976 | Makenzie Green | Case Manager/Care Coordinator | 27 S Main, Tooele, UT 84074 | 2018-06-07 |
| 1386151835 | Monica Lee | Physical Therapist | 6727 Ut-36 #300, Stansbury Park, UT 84074 | 2018-01-05 |
| 1871976183 | Pagnani Physical Therapy | Physical Therapist | 6727 North State Hwy 36, Suite 300, Stansbury Park, UT 84074 | 2015-07-06 |
| 1407248222 | Pebble Creek Counseling Center | Counselor | 494 E 2400 N Ste B, Tooele, UT 84074 | 2015-03-03 |
| 1528496221 | Emily Carlson | Case Manager/Care Coordinator | 220 North Millpond Rd, Suite 100, Stansbury Park, UT 84074 | 2013-10-16 |
| 1710327218 | Angela Michelle Demoss | Nurse Practitioner | 682 Country Club, Stansbury Park, UT 84074 | 2013-06-28 |
| Find all providers in zip 84074 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497989255 | Ihc Health Services Inc | Clinic/Center | 196 E 2000 N, Tooele, UT 84074-9335 | 2009-05-08 |
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| 1467082644 | Treatment Network LLC | Clinic/Center | 12608 S 125 W Ste B2, Draper, UT 84020-5443 | 2020-01-16 |
| 1750928214 | Kyunghee Seo K Mental Health Clinic | Clinic/Center | 1160 S State St Ste 160a, Orem, UT 84097-8263 | 2019-12-04 |
| 1740836345 | The Lift Clinic, LLC | Clinic/Center | 345 W 100 S # 6c, Slc, UT 84101-1209 | 2019-08-11 |
| 1952953101 | Restorative Health Primary Care | Clinic/Center | 850 E 9400 S Ste 101, Sandy, UT 84094-4114 | 2019-07-09 |
| 1063986800 | Healthworks Med Group of Utah P C | Clinic/Center | 4163 S 3200 W, West Valley City, UT 84119-5128 | 2019-01-15 |
| 1235615790 | Community Birth Group | Clinic/Center | 1190 E 5425 S Ste 330, South Ogden, UT 84403-4548 | 2018-07-17 |
| 1275044075 | Edge Medical Services Inc. | Clinic/Center | 959 W Sedge Ct, Farmington, UT 84025-2541 | 2017-10-19 |
| 1992214027 | National Birth Centers, Inc | Clinic/Center | 4345 S Vallejo Dr, Holladay, UT 84124-3756 | 2017-09-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.