Individual provider Active NPI

Tammy M Griffis, FNP-C

  • Family Nurse Practitioner
  • Trezevant, TN
National Provider Identifier
1407251267
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19264 Issued in TN
Practice address
45 Hurt St
Trezevant, TN 38258-2505
Phone
(731) 669-3863
Fax
(731) 731-6693
NPI assigned
Oct 22, 2014
Last updated
Jun 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 19264 TN Primary

Addresses

Primary practice location

45 Hurt St
Trezevant, TN 38258-2505

Mailing address

45 Hurt St
Trezevant, TN 38258-2505
Phone (731) 207-0323

Other practice location 1

1022 Greystone Sq
Jackson, TN 38305-3580
Phone (731) 300-2001

Other practice location 2

1123 N Main St
Dyer, TN 38330-1019
Phone (731) 692-2853

Other practice location 3

2062 Pleasant Plains Ext Rd Ste E
Jackson, TN 38305-6008
Phone (731) 664-2273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20141202001405 TN Practitioner - Nurse Practitioner 8820310824 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Medical Clinic of TrezevantGroup PAC ID 2860828936, 3 clinicians

Practice addresses (Care Compare)

1022 Greystone SQ
Jackson, TN 38305-3580
Phone (731) 300-2001

45 Hurt St
Trezevant, TN 38258-2505
Phone (731) 207-0323

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
19264TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Nov 5, 2014 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Nov 5, 2014 Accepting new patients
Family Medical Clinic of Trezevant CurrentSince Dec 1, 2019 Accepting new patients
T4T Current Accepting new patients
West Tennessee Healthcare Hospitalists Inc CurrentSince Jun 5, 2023 Accepting new patients
Family Medical Clinic of Trezevant PastSince Nov 21, 2021 Accepting new patients
Kentucky Addiction Centers Paintsville, LLC Family PastSince Mar 28, 2021 Accepting new patients

Locations

1022 Greystone Sq
Jackson, TN 38305
Phone (731) 300-2001

257 Bancorp South Pkwy
Jackson, TN 38305
Phone (731) 512-1283

620 Skyline Dr
Jackson, TN 38301
Phone (731) 425-5000

45 Hurt St
Trezevant, TN 38258
Phone (731) 207-0323

Organizations & group practices 7

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1407251267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 HURT ST",
            "city": "TREZEVANT",
            "state": "TN",
            "postal_code": "382582505",
            "telephone_number": "731-207-0323",
            "fax_number": "731-240-8065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 HURT ST",
            "city": "TREZEVANT",
            "state": "TN",
            "postal_code": "382582505",
            "telephone_number": "731-669-3863",
            "fax_number": "731-731-6693"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1022 Greystone Sq",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "383053580",
            "country_code": "US",
            "telephone_number": "731-300-2001",
            "fax_number": "731-240-8095",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1123 N Main St",
            "address_purpose": "LOCATION",
            "city": "Dyer",
            "state": "TN",
            "postal_code": "383301019",
            "country_code": "US",
            "telephone_number": "731-692-2853",
            "fax_number": "731-692-2367",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2062 Pleasant Plains Ext Rd Ste E",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "383056008",
            "country_code": "US",
            "telephone_number": "731-664-2273",
            "fax_number": "731-300-7405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIFFIS",
        "first_name": "TAMMY",
        "middle_name": "M",
        "name_prefix": "Miss",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-22",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "19264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trezevant, TN

Sources for this page

Verify at the official NPI Registry.