Jaclyn Marie Cecilia Griffith

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

32373 Issued in TN

Practice address

1723 Mount Vernon Dr NW
Cleveland, TN 37311-3539

Phone

(423) 473-2633

Fax

(423) 473-2643

NPI assigned

Sep 14, 2022

Last updated

Jan 24, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cleveland Psychiatric Center, PCGroup PAC ID 5799717526, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Cleveland Psychiatric Center, PC

  • Psychiatry Physician
  • Cleveland, TN
  • NPI 1972799146
  Medicare reassignment Care Compare group NPD
• Robert Stetson, MD, PLLC

  • Psychiatry Physician
  • Cleveland, TN
  • NPI 1326228602
  NPD

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

{
    "created_epoch": "1663113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1023730298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1723 MOUNT VERNON DR NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113539",
            "telephone_number": "423-473-2633",
            "fax_number": "423-473-2643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 MOUNT VERNON DR NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113539",
            "telephone_number": "423-473-2633",
            "fax_number": "423-473-2643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFITH",
        "first_name": "JACLYN",
        "middle_name": "MARIE CECILIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-14",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TN",
            "license": "32373",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "230136",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Alexander Green IV
• Elizabeth Marie Greene
• Judith Greene, MSN
• Sarah J Gregory, FNP-C
• Alison Griffith, PHARMD
• Patricia W Griner, DPH
• Madeline Lynne Grotefendt, NURSE PRACTITIONER
• Groups Recover Together
• Eric William Gruber, DC
• Wendy Lynn Gruber, DC

• Psychiatric/Mental Health Nurse Practitioner in Cleveland, TN
• Providers in Cleveland, TN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.