NPIMap

Individual provider Active NPI

Jennifer Graybill, DO

  • Internal Medicine Physician
  • St Petersburg, FL
National Provider Identifier
1497016406
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OS13602 Issued in FL
Practice address
1111 7TH Ave N Ste 107
St Petersburg, FL 33705-1348
Phone
(727) 894-1661
Fax
(727) 894-1430
NPI assigned
Jun 6, 2012
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS13602 FL
Rheumatology Physician 207RR0500X 266937 NY
Internal Medicine Physician 207R00000X OS13602 FL Primary

Addresses

Primary practice location

1111 7TH Ave N Ste 107
St Petersburg, FL 33705-1348

Mailing address

1111 7TH Ave N Ste 107
St Petersburg, FL 33705-1348
Phone (727) 894-1661

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL URL Health Information Exchange (HIE)
Other URL url Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160613002545 FL Practitioner - Internal Medicine 8628220902 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integritynp, LLCGroup PAC ID 9830479054, 14 clinicians

Practice addresses (Care Compare)

1114 Chatman Blvd
Brooksville, FL 34601-3104
Phone (352) 796-6701

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS13602FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integritynp, LLC CurrentSince Sep 12, 2021 Accepting new patients
Advanced Primary Care and Geriatrics PA Past Accepting new patients

Locations

1114 Chatman Blvd
Brooksville, FL 34601
Phone (352) 796-6701

37300 Royal Oak Ln
Dade City, FL 33525
Phone (352) 567-3122

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.

Hospital & facility affiliations 7

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": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1497016406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 7TH AVE N STE 107",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051348",
            "telephone_number": "727-894-1661",
            "fax_number": "727-894-1430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 7TH AVE N STE 107",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051348",
            "telephone_number": "727-894-1661",
            "fax_number": "727-894-1430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAYBILL",
        "first_name": "JENNIFER",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-06",
        "last_updated": "2023-11-27",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS13602",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NY",
            "license": "266937",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS13602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "URL",
            "affiliation": "Y",
            "endpointDescription": "Health Information Exchange",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Exchange",
            "address_1": "1111 7th Ave North",
            "address_2": "Ste 107",
            "city": "St Petersburg",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33705",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "url",
            "affiliation": "N",
            "endpointDescription": "emr",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1111 7th Ave N Ste 107",
            "city": "St Petersburg",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337051348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.