Mary Jane Pennington, MD | |
3725 W 4100 South, West Valley City, UT 84120 | |
(801) 965-3600 | |
(801) 965-3526 |
Full Name | Mary Jane Pennington |
---|---|
Gender | Female |
Speciality | Pediatric Medicine |
Experience | 39 Years |
Location | 3725 W 4100 South, West Valley City, Utah |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1205868452 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 1750881205 (Utah) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Granger Medical Clinic Pc | 3476465691 | 149 |
Granger Medical Specialists Llc | 4587074356 | 155 |
Entity Name | Granger Medical Clinic Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1184657041 PECOS PAC ID: 3476465691 Enrollment ID: O20031105000159 |
Entity Name | Granger Medical Specialists Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1376159368 PECOS PAC ID: 4587074356 Enrollment ID: O20201105002207 |
Mailing Address | Practice Location Address |
---|---|
Mary Jane Pennington, MD 3725 W 4100 South, West Valley City, UT 84120 Ph: (801) 965-3600 | Mary Jane Pennington, MD 3725 W 4100 South, West Valley City, UT 84120 Ph: (801) 965-3600 |
Dr. Mary E Shapiro, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 3730 W 4700 S, West Valley City, UT 84118 Phone: 801-213-9200 | |
Dr. Ryan K Frome, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 2965 W 3500 S, West Valley City, UT 84119 Phone: 801-965-3448 | |
Dr. Julie I Wilkerson, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3725 W 4100 S, West Valley City, UT 84120 Phone: 801-965-3600 Fax: 801-965-3526 | |
Alyson Eyre, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2965 W 3500 S, West Valley City, UT 84119 Phone: 801-965-3600 | |
Dana C Ostermiller, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 3725 W 4100 S, West Valley City, UT 84120 Phone: 801-965-3600 | |
Craig A Brasher, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2965 W 3500 S, West Valley City, UT 84119 Phone: 801-965-3600 |