Mary Jane Pennington

MD | Pediatrics | Female

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Complete Profile:

Mary Jane Pennington basic information including her official name, gender, specialization, credentials etc. are as mentioned below.

Specialization :	Pediatrics
Provider Name :	Mary Jane Pennington
Credential :	MD
Gender :	Female

Business Address:

Mary Jane Pennington address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.

Primary Address :	3725 W 4100 South West Valley City, UT, 84120 United States
Phone Number :	801-965-3600
Fax Number :	801-965-3526

Professional Identification Codes:

NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.

NPI Number :	1205868452
NPI Entity Type :	Individual
First Enrolment Date :	07 Jul, 2006
Last Updated On :	13 May, 2013

Medicare Participation:

Mary Jane Pennington participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.

Medicare PECOS ID :	4486566619
Medicare Enrollment ID :	I20061207000281
Primary Specialty :	Pediatric Medicine
Medical School :	Washington University School Of Medicine
Graduation Year :	1985
Accepts Medicare?	Yes. Mary Jane Pennington accepts medicare insurance.

Group Practice Association:

Mary Jane Pennington is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Mary Jane Pennington is associated with along with the number of members in that group. She may also accept medicare indirectly via these group practices.

Organisation Name :	Group Practice ID	No. of Members	Practice Address	Group Accepts Medicare
Granger Medical Clinic Pc	3476465691	84	7181 S Campus View Dr West Jordan, UT - 840844312 Ph: 8019653505	Yes
Granger Medical Clinic Pc	3476465691	84	12391 S 4000 Riverton, UT - 840967012 Ph: 8013021700	Yes
Granger Medical Clinic Pc	3476465691	84	348 E 4500 Suite 200 Salt Lake City, UT - 841078509 Ph: 8012629800	Yes

Licenses and Specialities:

Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mary Jane Pennington are as mentioned. Primary taxonomy code for Mary Jane Pennington, MD is 208000000X (Pediatrics).

Taxonomy Code	Speciality	Primary	License No.	State
208000000X	Pediatrics	Yes	1750881205	UT

Mailing Address:

Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.

Mailing Address :	3725 W 4100 South West Valley City, UT, 84120 United States
Phone Number :	801-965-3600
Fax Number :	801-965-3526

Business Location:

Patients can refer following map for directions to Mary Jane Pennington practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.