Jesse David Bane (NPI# 1477584837, PAC ID# 7911987920) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1477584837 |
| PAC ID by PECOS | 7911987920 |
| Professional Enrollment ID | I20040721000864 |
| Full Name | Jesse David Bane |
| Organization Legal Name | GRANGER MEDICAL CLINIC INC |
| Address |
3725 W 4100 West Valley City UT 84120-5530 |
| Phone Number | 8019653600 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS |
| Graduation Year | 1970 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 3476465691 |
| Number of Group Practice Members | 159 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 460051 | JORDAN VALLEY MEDICAL CENTER |
| 460047 | ST MARK'S HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 3725 W 4100, West Valley City, UT 84120-5530 | 8019653600 | GRANGER MEDICAL CLINIC INC |
| Organization Legal Name | GRANGER MEDICAL CLINIC INC |
| Physicians | 158 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Javier Eduardo Chavez | Obstetrics/gynecology | Granger Medical Clinic Inc | 3181 S 9000, West Jordan, UT 84088 |
| Ginette I Speed | Nurse Practitioner | Granger Medical Clinic Inc | 181 E 5600, Suite 130, Murray, UT 84107-6127 |
| Casey J Henich | Family Medicine | Granger Medical Clinic Inc | 3725 W 4100, West Valley City, UT 84120-5530 |
| Jared H Mathis | Physician Assistant | Granger Medical Clinic Inc | 2326 N 400 E, C203, Tooele, UT 84074-3408 |
| David George Dienhart | Internal Medicine | Granger Medical Clinic Inc | 71 E 1280, Tooele, UT 84074-8120 |
| Melisa S Steele | Nurse Practitioner | Granger Medical Clinic Inc | 1121 E 3900, Suite C130 Millcreek, Salt Lake City, UT 84124-1200 |
| Robert D Williams | Family Medicine | Granger Medical Clinic Inc | 1288 W 12700, Riverton, UT 84065-6794 |
| Ian R Cavin | General Surgery | Granger Medical Clinic Inc | 4252 S Highland Dr, Suite 200, Salt Lake City, UT 84124-2690 |
| Stephen B Devenport | Family Medicine | Granger Medical Clinic Inc | 12391 S 4000, Riverton, UT 84096-7012 |
| Edwin R England | Obstetrics/gynecology | Granger Medical Clinic Inc | 11724 S State St, Draper, UT 84020-7163 |
| Street Address |
3725 W 4100 |
| City | WEST VALLEY CITY |
| State | UT |
| Zip | 84120-5530 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Casey J Henich | Family Medicine | Granger Medical Clinic Inc | 3725 W 4100, West Valley City, UT 84120-5530 |
| Daniel Vernon Cahoon | Urology | Granger Medical Clinic Inc | 3725 W 4100, West Valley City, UT 84120-5530 |
| William H Burleigh | Podiatry | Granger Medical Clinic Inc | 3725 W 4100, West Valley City, UT 84120-5530 |
| Ashleigh A Byrne | Pain Management | Granger Medical Clinic Inc | 3725 W 4100, West Valley City, UT 84120-5530 |
| James S Mcintyre | Sports Medicine | Granger Medical Clinic Inc | 3725 W 4100, West Valley City, UT 84120-5530 |
| Rebekah Clifford | Dermatology | Granger Medical Clinic Inc | 3725 W 4100, West Valley City, UT 84120-5530 |
| Susan M Zimmerman | Neurology | Granger Medical Clinic Inc | 3725 W 4100, West Valley City, UT 84120-5530 |
| Pinky Kotwal | Internal Medicine | Granger Medical Clinic Inc | 3725 W 4100, West Valley City, UT 84120-5530 |
| Marie F Couldwell | Endocrinology | Granger Medical Clinic Inc | 3725 W 4100, West Valley City, UT 84120-5530 |
| Richard F Kennard | Diagnostic Radiology | Utah Imaging Associates Inc | 3725 W 4100, Granger Medical Clinic, West Valley City, UT 84120-5530 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lawrence B Grandy | Family Medicine | After Hours Medical LLC | 3451 S 5600 W F, After Hours Medical West Valley Clinic, Salt Lake City, UT 84120-1301 |
| Robert E Warrick | Family Practice | After Hours Medical LLC | 3451 S 5600 W F, After Hours Medical West Valley Clinic, Salt Lake City, UT 84120-1301 |
| Carlos A Vasquez | Nurse Practitioner | Physician Group of Utah Inc | 3336 S Pioneer Pkwy, Suite 204, West Valley City, UT 84120-2014 |
| Ravinder S Ahluwalia | Internal Medicine | Santibanez Aguirre Slc PC | 3460 S Pioneer Pkwy, Salt Lake City, UT 84120-2049 |
| Jason E Crook | Nurse Practitioner | Santibanez Aguirre Slc PC | 3460 S Pioneer Pkwy, Salt Lake City, UT 84120-2049 |
| Rocky D Howell | Nurse Practitioner | Physician Group of Utah Inc | 3460 S Pioneer Pkwy, Suite 304, West Valley City, UT 84120-2049 |
| Peter C Agy | Internal Medicine | Santibanez Aguirre Slc PC | 3460 S Pioneer Pkwy, Salt Lake City, UT 84120-2049 |
| Gayle M Stewart | Obstetrics/gynecology | Physician Group of Utah Inc | 3460 S Pioneer Pkwy, West Valley, UT 84120-2049 |
| Merwin D Rasmussen | Certified Registered Nurse Anesthetist | 3460 S Pioneer Pkwy, West Valley, UT 84120-2049 | |
| Michelle M Sticka | Clinical Social Worker | Physician Group of Utah Inc | 3460 S Pioneer Pkwy, Pioneer Valley Hospital A Campus of Jordan Valley Medi, West Valley City, UT 84120-2049 |
| Find all physicians in zip 84120 | |||
| City | WEST VALLEY CITY |
| Zip Code | 84120 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | WEST VALLEY CITY + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Jesse David Bane.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.