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Granger Medical Clinic PC

Family Medicine Physician in Draper, UT · enumerated 2013 · authorized official Mary Jane Pennington, President.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1174968051

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Registry record

Entity type Organization (Type 2)
Legal business name Granger Medical Clinic PC
Other name <Unavail>
Parent organization Granger Medical Clinic PC
Practice address 11724 South State St., Draper, UT, 84020
Phone (801) 965-3600
Fax (801) 965-3740
Enumeration date May 6, 2013
Last updated in NPPES Dec 13, 2023

Taxonomy & classification

207N00000X Dermatology Physician Allopathic & Osteopathic Physicians Secondary
207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians Primary
207R00000X Internal Medicine Physician Allopathic & Osteopathic Physicians Secondary
207RG0100X Gastroenterology Physician Allopathic & Osteopathic Physicians Secondary
207RN0300X Nephrology Physician Allopathic & Osteopathic Physicians Secondary
207RP1001X Pulmonary Disease Physician Allopathic & Osteopathic Physicians Secondary
207RS0010X Sports Medicine (Internal Medicine) Physician Allopathic & Osteopathic Physicians Secondary
207RS0012X Sleep Medicine (Internal Medicine) Physician Allopathic & Osteopathic Physicians Secondary
207V00000X Obstetrics & Gynecology Physician Allopathic & Osteopathic Physicians Secondary
207W00000X Ophthalmology Physician Allopathic & Osteopathic Physicians Secondary
207X00000X Orthopaedic Surgery Physician Allopathic & Osteopathic Physicians Secondary
207Y00000X Otolaryngology Physician Allopathic & Osteopathic Physicians Secondary
208000000X Pediatrics Physician Allopathic & Osteopathic Physicians Secondary
208200000X Plastic Surgery Physician Allopathic & Osteopathic Physicians Secondary
208VP0000X Pain Medicine Physician Allopathic & Osteopathic Physicians Secondary

Authorized official

Name Mary Jane Pennington
Title President
Phone (801) 965-3600

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

Who is the authorized official for Granger Medical Clinic PC?
NPPES lists Mary Jane Pennington (President) as the authorized official for this organization.
What is the NPI number for Granger Medical Clinic PC?
The NPI for Granger Medical Clinic PC is 1174968051, a Type 2 (organization) record in the CMS NPPES registry.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2023-12-13.