Amanda Rose Griffin

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

116 Meridian Dr
Woodstock, GA 30188-1604

Phone

(770) 880-4541

NPI assigned

Sep 23, 2022

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

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

Medicare enrollment (NPD)

Enrolled

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.

• The Bortolazzo Group, LLC

  • Emergency Medicine Physician
  • Austell, GA
  • NPI 1801965082
  Medicare reassignment

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

{
    "created_epoch": "1663891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1326761354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 MERIDIAN DR",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301881604",
            "telephone_number": "770-880-4541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 MERIDIAN DR",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301881604",
            "telephone_number": "770-880-4541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "AMANDA",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-23",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lana Danielle Greene, MA, LPC, NCC
• Haley Greenlee
• Gregg Chiropractic Center, Inc.
• Brian Glen Gregg, DC
• Jackson Kelley Griffeth, DMD, MSD
• Erin Johnson Grigsby, P.T.
• Grisham Associates LTD
• Gabriel Leonard Grisham, DMD
• Milton Grisham, PHD
• Timothy Gross, AMFT

• Physician Assistant in Woodstock, GA
• Providers in Woodstock, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; 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.