Active NPI
Internal Medicine of Griffin
- Specialist
- Griffin, GA
National Provider Identifier
1073562633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Legal business name
- INTERNAL MEDICINE OF GRIFFIN
- Practice address
- 231 Graefe St
Griffin, GA 30224-4222 - Phone
- (770) 227-1587
- Fax
- (770) 227-1485
- NPI assigned
- May 9, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Melisa Skipper
- Title
- Practice Adm
- Phone
- (770) 227-1587
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Primary |
Addresses
Primary practice location
231 Graefe St
Griffin, GA 30224-4222
Mailing address
231 Graefe St
Griffin, GA 30224-4222
Phone (770) 227-1587
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040521000182 | GA | Part B Supplier - Clinic/Group Practice | 2961493697 |
Receives reassigned benefits from 27 practitioners Practice locations: Griffin, GA |
National Provider Directory
National Provider DirectoryLocations
303 Charlie Watts Dr
Ste A
Dallas, GA 30157
Phone (404) 446-3870
Practitioners & affiliated clinicians
Practitioners 30
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147132800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1413504000000",
"number": "1073562633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "231 GRAEFE ST",
"city": "GRIFFIN",
"state": "GA",
"postal_code": "302244222",
"telephone_number": "770-227-1587",
"fax_number": "770-227-1485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "231 GRAEFE ST",
"city": "GRIFFIN",
"state": "GA",
"postal_code": "302244222",
"telephone_number": "770-227-1587",
"fax_number": "770-227-1485"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INTERNAL MEDICINE OF GRIFFIN",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-09",
"last_updated": "2014-10-17",
"status": "A",
"authorized_official_last_name": "SKIPPER",
"authorized_official_first_name": "MELISA",
"authorized_official_title_or_position": "PRACTICE ADM",
"authorized_official_telephone_number": "770-227-1587",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Griffin, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.