Jackie Tanner Griffin, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

900292 Issued in NC

Practice address

3803 N Elm St
Greensboro, NC 27455-2593

Phone

(336) 540-7075

Fax

(888) 882-3919

NPI assigned

Dec 13, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Community Family Medicine and Obstetrics, P.a.

  • Family Medicine Physician
  • Sanford, NC
  • NPI 1720094543
  NPD (past)

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433721600000",
    "number": "1316922339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3803 N ELM ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274552593",
            "telephone_number": "336-540-7075",
            "fax_number": "888-882-3919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3803 N ELM ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274552593",
            "telephone_number": "336-540-7075",
            "fax_number": "888-882-3919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "JACKIE",
        "middle_name": "TANNER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-13",
        "last_updated": "2015-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "900292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2328528",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Griffin, MSW, LCSWA
• Beth Griffin, SLP
• Charity Brown Griffin, PHD
• Crystal Griffin, NP
• Elaine C Griffin, MD
• Jessica Tilson Griffin, LCHMCA
• John Griffin, MD
• Keri Griffin, LMBT#18320
• Kimberly L. Griffin, LCSW
• Lauren Griffin, EDD

• Family Nurse Practitioner in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.