Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mary Jane Pennington, MD

Individual provider Pediatrics Physician · NPI 1205868452

Mary Jane Pennington, MD is a Pediatric Medicine in West Valley City, Utah. Graduated from Washington University School of Medicine in 1985, 41 years ago. Practices with Granger Medical Clinic PC, a 191-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
41
Trained at
Washington University School of Medicine
Licensed in
UT
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2965 W 3500 S
West Valley City, UT 84119-3602
Phone: (801) 965-3600
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 1750881205 (UT)

Record details

NPI number1205868452
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 7, 2006
Last updated in NPPESOctober 3, 2024
Certification dateOctober 3, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPEDIATRIC MEDICINE
Medical schoolWASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Graduated 1985 (41 years in practice)
Group practice Granger Medical Clinic Pc — 191 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in West Valley City