GRANITE PEAKS PATHOLOGY P.C. (NPI# 1124277496) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124277496 |
| Entity Type | Organization |
| Organization Name | GRANITE PEAKS PATHOLOGY P.C. |
| Other Organization Name | GRANITE PEAKS PATHOLOGY |
| Practice Address |
1393 E Sego Lily Dr Sandy UT 84092-4350 |
| Practice Telephone | 8016199000 |
| Practice Fax Number | 8016199001 |
| Mailing Telephone | 8016199000 |
| Mailing Fax Number | 8016199001 |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2016-09-27 |
| Authorized Official Name | ROBERT KYLE BARNETT (PRESIDENT) |
| Authorized Official Telephone | 8016199000 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ZP0105X |
Pathology Specialization: Clinical Pathology/Laboratory Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Granite Peaks Pathology | Doing Business As Name - Organization |
| Street Address |
1393 E SEGO LILY DR |
| City | SANDY |
| State | UT |
| Zip Code | 84092-4350 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134119357 | Robert Kyle Barnett | Internal Medicine | 1393 E Sego Lily Dr, Sandy, UT 84092-4350 | 2005-10-27 |
| 1932728813 | Rachel Hansen | Physician Assistant | 1393 E Sego Lily Dr, Sandy, UT 84092-4350 | 2020-04-10 |
| 1881169043 | Scott Richard Moffitt | Internal Medicine | 1393 E Sego Lily Dr, Sandy, UT 84092-4350 | 2018-10-03 |
| 1417467135 | Christine Weaver | Physician Assistant | 1393 E Sego Lily Dr, Sandy, UT 84092-4350 | 2017-10-08 |
| 1205387008 | Granite Peaks Pathology II LLC. | Pathology | 1393 E Sego Lily Dr, Sandy, UT 84092-4350 | 2016-10-18 |
| 1083926331 | Sarah Mary Holland | Registered Nurse | 1393 E Sego Lily Dr, Sandy, UT 84092-4350 | 2010-07-01 |
| 1689872897 | Granite Peaks Gi, LLC | Internal Medicine | 1393 E Sego Lily Dr, Sandy, UT 84092-4350 | 2007-07-10 |
| 1104022557 | James Muir Stewart | Specialist | 1393 E Sego Lily Dr, Sandy, UT 84092-4350 | 2007-06-22 |
| 1790891430 | Steven Gregg Desautels | Internal Medicine | 1393 E Sego Lily Dr, Sandy, UT 84092-4350 | 2006-08-23 |
| 1437162013 | Christopher Scott Cutler | Internal Medicine | 1393 E Sego Lily Dr, Sandy, UT 84092-4350 | 2006-08-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922580687 | Michael L Wolf | Registered Nurse | 9915 S 2240 E, Sandy, UT 84092 | 2018-08-29 |
| 1780193763 | Marcia Marie Mitchell | Internal Medicine | 4 Longwood Lane, Sandy, UT 84092 | 2017-09-22 |
| 1154737427 | Sandy Shores Pediatric Dentistry | Dentist | 1434 E. 9400 S. #205, Sandy, UT 84092 | 2014-07-08 |
| 1629349915 | David Adams | Counselor | 10306 South 2375 East, Alta, UT 84092 | 2012-01-19 |
| 1043511587 | Edward Chipman Spencer | Orthopaedic Surgery | 3260 East 9425 South, Sandy, UT 84092 | 2010-11-16 |
| 1669785440 | David Jonathan Wilde | Counselor | 10038 S Countrywood Dr, Sandy, UT 84092 | 2010-07-21 |
| 1396057592 | Joshua Taylor Silva | Preventive Medicine | 2878 E Wasatch Blvd, Sandy, UT 84092 | 2010-07-06 |
| 1467619809 | Deborah J. Dean | Clinical Nurse Specialist | 9768 Eastdell Dr, Sandy, UT 84092 | 2008-05-22 |
| 1780781682 | Michael Ryan Adams | Family Medicine | 7998 South 1300 East, Sandy, UT 84092 | 2006-09-20 |
| 1194853390 | William S Hoge | Pharmacist | 9500 E Little Cottonwood Cny Rd, Snowbird, UT 84092-0000 | 2007-03-01 |
| Find all providers in zip 84092 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164627576 | Terry H Rich | Pathology | 15 Sunwood Ln, Sandy, UT 84092-4802 | 2007-06-15 |
| 1205387008 | Granite Peaks Pathology II LLC. | Pathology | 1393 E Sego Lily Dr, Sandy, UT 84092-4350 | 2016-10-18 |
| 1114907805 | Hugh J Roddy | Pathology | 10011 Centennial Pkwy, Suite 300, Sandy, UT 84070-4156 | 2006-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659746535 | Lmd Path, Inc | Pathology | 1018 S 350 E, Provo, UT 84606-6152 | 2015-12-03 |
| 1376970772 | Pathology Services of Utah | Pathology | 400 E 1600 S, Mapleton, UT 84664-5205 | 2013-09-30 |
| 1962842864 | Matthew Scott Johnson | Pathology | 2000 Circle of Hope Dr Rm N3100, Salt Lake City, UT 84112-5550 | 2013-06-25 |
| 1578852661 | Jolanta Jedrzkiewicz | Pathology | 434 2nd Ave Apt 4, Salt Lake City, UT 84103-5623 | 2011-03-30 |
| 1861714768 | Mtd Medical Services, LLC | Pathology | 290 N Red Slide Dr, Wellsville, UT 84339-9757 | 2010-02-18 |
| 1891922951 | Thomas Cary Wilson | Pathology | 5330 S 900 E Ste 120, Salt Lake City, UT 84117-3504 | 2009-06-16 |
| 1780822809 | Dana Claire Gingell | Pathology | 1372 S 300 E, Salt Lake City, UT 84115-1502 | 2009-01-27 |
| 1639315070 | Benjamin Lloyd Witt | Pathology | University of Utah 50 N Medical Dr, Department of Pathology, Salt Lake City, UT 84132-0001 | 2009-01-06 |
| 1619130036 | Jeremy Wallentine | Pathology | 2913 Garden Meadows Cv, Slc, UT 84106-1302 | 2008-07-07 |
| 1164683959 | Jessica Comstock | Pathology | 100 N Mario Cappechi Dr, Primary Childrens Medical Center Dept of Pathology, Salt Lake City, UT 84113 | 2008-06-24 |
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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.