NPIMap

Individual provider Active NPI

Jacob Ryan Griffith

  • Physician Assistant
  • Knoxville, TN
National Provider Identifier
1023553872
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
9125 Cross Park Dr Ste 200
Knoxville, TN 37923-4563
Phone
(865) 632-5900
NPI assigned
Jan 4, 2017
Last updated
Aug 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

9125 Cross Park Dr Ste 200
Knoxville, TN 37923-4563

Mailing address

9125 Cross Park Dr Ste 200
Knoxville, TN 37923-4563
Phone (865) 632-5900

Other identifiers 1

IdentifierTypeStateIssuer
Q030515MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address griffith.jacob@covenanthealth.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, IA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170330000803 TN Practitioner - Physician Assistant 6406131648 Reassigns benefits to 3 organizations
I20220912003209 IA Practitioner - Physician Assistant 6406131648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Iowa Mercy ClinicsGroup PAC ID 7810809076, 304 clinicians
Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians
East Tennessee Cardiovascular Surgery Group PCGroup PAC ID 6608934203, 20 clinicians

Practice addresses (Care Compare)

1000 4TH St SW
Mason City, IA 50401-2800

635 E US Hwy 9
Mercyone Forest City Family Medicine
Forest City, IA 50436-1028
Phone (641) 585-2904

9125 Cross Park Dr
Suite 200
Knoxville, TN 37923-4563
Phone (865) 632-5900

9330 Park W Blvd
Suite 100
Knoxville, TN 37923-4309
Phone (865) 632-5900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.55 of 100Reported as group
Quality
73.89
Promoting interoperability
93
Improvement activities
40
Cost
70.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3214TNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Crossville Family Medicine LLC Current Accepting new patients
University Health System Inc CurrentSince Aug 1, 2017 Accepting new patients
University Health System, Inc CurrentSince Aug 1, 2017 Accepting new patients
North Iowa Mercy Clinics Physician Assistant CurrentSince Jul 24, 2022 Accepting new patients
North Iowa Mercy Clinics Current Accepting new patients
North Iowa Mercy Clinics CurrentSince Jul 24, 2022 Accepting new patients

Locations

250 S Crescent Dr
Mason City, IA 50401
Phone (541) 422-6588

1645 S Main St
Ste 101
Crossville, TN 38555
Phone (931) 484-7531

1940 Alcoa Hwy
Ste E260
Knoxville, TN 37920
Phone (865) 305-6955

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1483488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1023553872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9125 CROSS PARK DR STE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234563",
            "telephone_number": "865-632-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9125 CROSS PARK DR STE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234563",
            "telephone_number": "865-632-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFITH",
        "first_name": "JACOB",
        "middle_name": "RYAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-04",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q030515",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "griffith.jacob@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "9125 Cross Park Dr Ste 200",
            "city": "Knoxville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "379234563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.