Organization Active NPI

Griffith Family Medicine, PLLC

  • Family Medicine Physician
  • Nacogdoches, TX
National Provider Identifier
1346661709
Registry record updated Jan 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GRIFFITH FAMILY MEDICINE, PLLC
Practice address
1023 N Mound St
Suite a
Nacogdoches, TX 75961-4491
Phone
(936) 564-2691
Fax
(936) 560-5224
NPI assigned
Jan 2, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2014

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

Authorized official

Name
Robert Griffith, FNP-C
Title
Owner
Phone
(936) 564-2691

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1023 N Mound St
Suite a
Nacogdoches, TX 75961-4491

Mailing address

PO Box 345
Mt Enterprise, TX 75681-0345
Phone (936) 564-2691

Other identifiers 1

IdentifierTypeStateIssuer
203375501MedicaidTX

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1388620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388620800000",
    "number": "1346661709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 345",
            "city": "MT ENTERPRISE",
            "state": "TX",
            "postal_code": "756810345",
            "telephone_number": "936-564-2691",
            "fax_number": "936-560-5224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 N MOUND ST",
            "address_2": "SUITE A",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614491",
            "telephone_number": "936-564-2691",
            "fax_number": "936-560-5224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRIFFITH FAMILY MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-02",
        "last_updated": "2014-01-02",
        "status": "A",
        "authorized_official_last_name": "GRIFFITH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "936-564-2691",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203375501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nacogdoches, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2014; 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.