Nicole Lydia Griffis, BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

BACB480828 Issued in FL

Practice address

1229 Airport Rd
Panama City, FL 32405-3527

Phone

(850) 215-6770

NPI assigned

Feb 27, 2019

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Dogwood Autism Services, LLC

  • Behavior Analyst
  • Atlanta, GA
  • NPI 1437674587
  NPD (past)

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

{
    "created_epoch": "1551225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1124585906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5280 SNAPFINGER PARK DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300354044",
            "telephone_number": "877-288-4760",
            "fax_number": "404-600-1259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 AIRPORT RD",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324053527",
            "telephone_number": "850-215-6770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5280 Snapfinger Park Dr",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300354044",
            "country_code": "US",
            "telephone_number": "877-288-4760",
            "fax_number": "404-600-1259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIFFIS",
        "first_name": "NICOLE",
        "middle_name": "LYDIA",
        "name_prefix": "Ms.",
        "credential": "BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-27",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": "RBT-19-78197",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "BACB480828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Gresham
• Miles T Grice IV
• Jocelyn Hope Grider
• Bruce Alan Griffin, LMHC
• Jessica Griffin, LMHC
• Reilly Morgan Griffith, PA-C
• Vanessa Rae Grimes, L.M.
• Danielle Janine Grontas, APRN
• Angela Gruber
• Guillot Enterprises, LLC

• Behavior Analyst in Panama City, FL
• Providers in Panama City, FL by specialty
• Behavior Analyst in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.