Jackie R Griffiths, RD,LN

Primary specialty

Renal Nutrition Registered DietitianTaxonomy code 133VN1005X

License

736 Issued in ND

Practice address

4474 23Rd Ave S Ste M
Fargo, ND 58104-8795

Phone

(701) 282-2635

NPI assigned

Jan 3, 2008

Sex

Female

Sole proprietor

Yes

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)

Enrolled

State licenses

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

{
    "created_epoch": "1199318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199318400000",
    "number": "1386829844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 EVERGREEN CIR",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580781201",
            "telephone_number": "701-866-9352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4474 23RD AVE S STE M",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048795",
            "telephone_number": "701-282-2635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFITHS",
        "first_name": "JACKIE",
        "middle_name": "R",
        "credential": "RD,LN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-03",
        "last_updated": "2008-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ND",
            "license": "736",
            "primary": false
        },
        {
            "code": "133VN1005X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "ND",
            "license": "736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kailey Lynn Grey, PA-C
• Michael Griess, MD
• David M Griffin, MD
• Douglas M Griffin, MD
• Annika Griffith
• Hayat Ameera Grimes
• Allyson Grimley
• Carol Jean Grimm, MD
• Terrence E Grimm, MD
• Garfield M Grimmett, MD

• Renal Nutrition Registered Dietitian in Fargo, ND
• Providers in Fargo, ND by specialty
• Renal Nutrition Registered Dietitian in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; 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.