Active NPI
Alvin Perry Griffith, M.D.
- Psychiatry Physician
- Bloomington, IN
National Provider Identifier
1063434587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 01038181A
- Practice address
- 601 W 2ND St
Bloomington, IN 47403-2317 - Phone
- (812) 353-5603
- Fax
- (812) 353-3451
- NPI assigned
- Jul 24, 2006
- Last updated
- Dec 29, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 01038181A | IN | Primary |
Addresses
Primary practice location
601 W 2ND St
Bloomington, IN 47403-2317
Mailing address
601 W 2ND St
Bloomington, IN 47403-2317
Phone (812) 353-5603
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100462920A | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1419811200000",
"number": "1063434587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 W 2ND ST",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474032317",
"telephone_number": "812-353-5603",
"fax_number": "812-353-3451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 W 2ND ST",
"city": "BLOOMINGTON",
"state": "IN",
"postal_code": "474032317",
"telephone_number": "812-353-5603",
"fax_number": "812-353-3451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIFFITH",
"first_name": "ALVIN",
"middle_name": "PERRY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-24",
"last_updated": "2014-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IN",
"license": "01038181A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100462920A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bloomington, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.