Individual provider Active NPI

Kandi Cheri Griffin, AGNP-C

  • Gerontology Nurse Practitioner
  • Greenville, SC
National Provider Identifier
1487540365
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
30361 Issued in SC
Practice address
8595 Pelham Rd # 320
Greenville, SC 29615-5759
Phone
(864) 316-8984
NPI assigned
Jun 16, 2025
Last updated
Jun 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 30361 SC Primary

Addresses

Primary practice location

8595 Pelham Rd # 320
Greenville, SC 29615-5759

Mailing address

8595 Pelham Rd # 320
Greenville, SC 29615-5759
Phone (864) 316-8984

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20250904003061 SC Practitioner - Nurse Practitioner 5294237707 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

104 Rockbridge CT
Liberty, SC 29657-8906

3090 Bristol St
Suite 200
Costa Mesa, CA 92626-3034

350 Bedford St
Suite 406a
Stamford, CT 06901-1738

677 Broadway
Suite 7
Albany, NY 12207-2553

8595 Pelham Rd
Suite 400
Greenville, SC 29615-5763

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Careconnectmd South Carolina P.C. CurrentSince Sep 1, 2025 Accepting new patients
Psgsc MSSP, P.C. CurrentSince Sep 28, 2025 Accepting new patients
Physicians Services Group, P.C. CurrentSince Jul 1, 2025 Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

2 Griffith Rd
Greenville, SC 29607
Phone (864) 276-8583

8595 Pelham Rd
Ste 400
Greenville, SC 29615
Phone (864) 316-8964

1240 Winnowing Way
Unit 102
Mt Pleasant, SC 29466
Phone (828) 396-5634

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1750032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1487540365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8595 PELHAM RD # 320",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296155759",
            "telephone_number": "864-316-8984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8595 PELHAM RD # 320",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296155759",
            "telephone_number": "864-316-8984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "KANDI",
        "middle_name": "CHERI",
        "credential": "AGNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-16",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "SC",
            "license": "30361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.