Individual provider Active NPI

Charlotte Ann Griffith, NP-C

  • Nurse Practitioner
  • Toccoa, GA
National Provider Identifier
1124380761
Registry record updated Jun 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
174985 Issued in GA
Practice address
58 Big a Road
Toccoa, GA 30577-6017
Phone
(706) 886-6819
Fax
(703) 282-5368
NPI assigned
Jun 11, 2012
Last updated
Jun 25, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 174985 GA Primary

Addresses

Primary practice location

58 Big a Road
Toccoa, GA 30577-6017

Mailing address

58 Big a Rd
Toccoa, GA 30577-6017
Phone (706) 886-6819

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20120720000249 GA Practitioner - Nurse Practitioner 8921264896 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

218 Falls Rd
Toccoa, GA 30577-1631
Phone (706) 282-5840

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
174985GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Toccoa Clinic Medical Associates, LLP Current Accepting new patients
Stephens County Hospital Physician Group LLC CurrentSince Mar 25, 2020 Accepting new patients
Stephens County Hospital Physician Group, LLC CurrentSince Mar 25, 2020 Accepting new patients
Stephens County Hospital Physician Group, LLC Past Accepting new patients

Locations

12192 Augusta Rd
Lavonia, GA 30553
Phone (706) 356-1072

58 Big a Rd
Toccoa, GA 30577
Phone (706) 886-3148

218 Falls Rd
Toccoa, GA 30577
Phone (706) 282-5840

115 Rock Quarry Rd
Toccoa, GA 30577
Phone (706) 282-5815

Interoperability endpoints

  • Direct secure messaging: charlotte.griffith.1@14936.direct.athenahealth.com

Organizations & group practices 4

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 2

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": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435190400000",
    "number": "1124380761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 BIG A RD",
            "city": "TOCCOA",
            "state": "GA",
            "postal_code": "305776017",
            "telephone_number": "706-886-6819",
            "fax_number": "706-282-5368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 BIG A ROAD",
            "city": "TOCCOA",
            "state": "GA",
            "postal_code": "305776017",
            "telephone_number": "706-886-6819",
            "fax_number": "703-282-5368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFITH",
        "first_name": "CHARLOTTE",
        "middle_name": "ANN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-11",
        "last_updated": "2015-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "174985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toccoa, GA

Sources for this page

Verify at the official NPI Registry.