Individual provider Active NPI

Katherine P Griffis, ARNP

  • Nurse Practitioner
  • Gulfport, MS
National Provider Identifier
1487673406
Registry record updated Dec 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R887779 Issued in MS
Practice address
38 Pass Rd Ste a
Gulfport, MS 39507-3107
Phone
(228) 865-1330
Fax
(228) 865-1331
NPI assigned
Jul 19, 2006
Last updated
Dec 22, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP3396982 FL
Nurse Practitioner 363L00000X R887779 MS Primary

Addresses

Primary practice location

38 Pass Rd Ste a
Gulfport, MS 39507-3107

Mailing address

38 Pass Rd Ste a
Gulfport, MS 39507-3107
Phone (228) 865-1330

Other identifiers 2

IdentifierTypeStateIssuer
Y1066OtherFLBLUE CROSS BLUE SHIELD
304688500MedicaidFL

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R887779MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hematology & Oncology Center P.a. Past Accepting new patients
Tampa Bay Radiation Oncology, PA PastSince Jan 7, 2003 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/_equjXi-I6k5_iN9ulQyh3xNMVDgQ7-w/

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.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482364800000",
    "number": "1487673406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 PASS RD STE A",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395073107",
            "telephone_number": "228-865-1330",
            "fax_number": "228-865-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 PASS RD STE A",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395073107",
            "telephone_number": "228-865-1330",
            "fax_number": "228-865-1331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIS",
        "first_name": "KATHERINE",
        "middle_name": "P",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2016-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP3396982",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R887779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Y1066",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "304688500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2016; 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.