| Granite Peaks Gi, Llc | |
|
1393 E Sego Lily Dr Sandy UT 84092-4350 | |
| (801) 619-9000 | |
| (801) 619-9001 |
| Full Name | Granite Peaks Gi, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1393 E Sego Lily Dr, Sandy, Utah |
| Authorized Official Name and Position | Christopher S Cutler (PHYSICIAN) |
| Authorized Official Contact | 8016199000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Granite Peaks Gi, Llc 1393 E Sego Lily Dr Sandy UT 84092-4350 Ph: (801) 619-9000 | Granite Peaks Gi, Llc 1393 E Sego Lily Dr Sandy UT 84092-4350 Ph: (801) 619-9000 |
| NPI Number | 1689872897 |
|---|---|
| Provider Enumeration Date | 07/10/2007 |
| Last Update Date | 12/28/2018 |
| Medicare PECOS PAC ID | 5395920110 |
|---|---|
| Medicare Enrollment ID | O20110420000821 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689872897 | NPI | - | NPPES |
| DR8477 | Other | UT | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 2901281205 (Utah) | Primary |
| Provider Name | Christopher S Cutler |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1437162013 PECOS PAC ID: 8729077540 Enrollment ID: I20070817000310 |
| Provider Name | Steven G Desautels |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1790891430 PECOS PAC ID: 0941213375 Enrollment ID: I20070817000333 |
| Provider Name | Andrew M Heiner |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1497768014 PECOS PAC ID: 3577576909 Enrollment ID: I20070823000533 |
| Provider Name | Robert Kyle Barnett |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1134119357 PECOS PAC ID: 7012929862 Enrollment ID: I20080328000078 |
| Provider Name | John David Schmidt |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1972760106 PECOS PAC ID: 4082692207 Enrollment ID: I20080619000360 |
| Provider Name | James M Stewart |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104022557 PECOS PAC ID: 7214129006 Enrollment ID: I20101012000852 |
| Provider Name | Michael J Weaver |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1720427974 PECOS PAC ID: 5395966816 Enrollment ID: I20210616002532 |
| Provider Name | Mark A Jensen |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1912384389 PECOS PAC ID: 3678867819 Enrollment ID: I20210616003207 |
| Provider Name | Alexandra Evelyn Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831831593 PECOS PAC ID: 3678951241 Enrollment ID: I20220609003115 |
| Provider Name | Whitney Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740922400 PECOS PAC ID: 5496133068 Enrollment ID: I20220609003119 |
| Provider Name | Sara Anne Kaiser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720768518 PECOS PAC ID: 6608223904 Enrollment ID: I20231108001133 |
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