Active NPI
Valerie J Griffin, APRN BC
- Pediatric Nurse Practitioner
- Glen Carbon, IL
National Provider Identifier
1407021504
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 209000207
- Practice address
- 6 Gray Cub CT
Glen Carbon, IL 62034-1396 - Phone
- (618) 218-6667
- NPI assigned
- Apr 29, 2008
- Last updated
- Dec 4, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 209000207 | IL | Primary |
Addresses
Primary practice location
6 Gray Cub CT
Glen Carbon, IL 62034-1396
Mailing address
6 Gray Cub CT
Glen Carbon, IL 62034-1396
Phone (618) 218-6667
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036090116 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209000207 | IL | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| David C. Norman MD Inc | Past | Accepting new patients | |
| Kristin Stahl MD PC | Past | Accepting new patients |
Interoperability endpoints
- valerie.griffin@hp-il.direct.office.nextgen.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pediatric Adolescent Medicine Physician
- Belleville, IL
- NPI 1841475746
-
dba Dale Avenue Pediatrics
- Primary Care Clinic/Center
- Collinsville, IL
- NPI 1336209329
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701648000000",
"number": "1407021504",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 GRAY CUB CT",
"city": "GLEN CARBON",
"state": "IL",
"postal_code": "620341396",
"telephone_number": "618-218-6667"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 GRAY CUB CT",
"city": "GLEN CARBON",
"state": "IL",
"postal_code": "620341396",
"telephone_number": "618-218-6667"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIFFIN",
"first_name": "VALERIE",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "APRN BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-29",
"last_updated": "2023-12-04",
"certification_date": "2022-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "IL",
"license": "209000207",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036090116",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Glen Carbon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.