Individual provider Active NPI

Michael Griffith

  • Medical Physician Assistant
  • West Jefferson, NC
National Provider Identifier
1366432270
Registry record updated Feb 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
952 US Highway 221 Business
West Jefferson, NC 28694-0070
Phone
(336) 846-6100
NPI assigned
Oct 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

952 US Highway 221 Business
West Jefferson, NC 28694-0070

Mailing address

PO Box 70
West Jefferson, NC 28694-0070
Phone (336) 846-6100

Other identifiers 1

IdentifierTypeStateIssuer
2759384OtherMEDICARE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090304000554 NC Practitioner - Physician Assistant 8123184801 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Derek McClure CurrentSince May 19, 2024 Accepting new patients
Wake Forest University Health Sciences Past Accepting new patients

Locations

952 US Highway 221 Bus
West Jefferson, NC 28694
Phone (336) 846-6100

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454976000000",
    "number": "1366432270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70",
            "city": "WEST JEFFERSON",
            "state": "NC",
            "postal_code": "286940070",
            "telephone_number": "336-846-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "952 US HIGHWAY 221 BUSINESS",
            "city": "WEST JEFFERSON",
            "state": "NC",
            "postal_code": "286940070",
            "telephone_number": "336-846-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFITH",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2016-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "2759384",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Jefferson, NC

Sources for this page

Verify at the official NPI Registry.