Organization Active NPI

Ryan Griffin, MD LLC

  • Internal Medicine Physician
  • Ponte Vedra, FL
National Provider Identifier
1508223363
Registry record updated Jan 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME96167 Issued in FL
Legal business name
RYAN GRIFFIN, MD LLC
Practice address
238 Canal Blvd
Suite 2
Ponte Vedra, FL 32082-3741
Phone
(904) 395-3041
Fax
(904) 834-7276
NPI assigned
Jan 25, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2016

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

Authorized official

Name
Ryan L Griffin, M.D.
Title
President
Phone
(904) 395-3041

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X ME96167 FL Primary

Addresses

Primary practice location

238 Canal Blvd
Suite 2
Ponte Vedra, FL 32082-3741

Mailing address

238 Canal Blvd
Suite 2
Ponte Vedra, FL 32082-3741
Phone (904) 395-3041

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2104562Ryan Griffin MD238 Canal Blvd Ste 2, Ponte Vedra, FL 32082Certificate of waiverNov 5, 2027

National Provider Directory

National Provider Directory

Locations

238 Canal Blvd
Ste 2
Ponte Vedra Beach, FL 32082
Phone (904) 395-3041

NPI Registry JSON

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

{
    "created_epoch": "1453680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453680000000",
    "number": "1508223363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 CANAL BLVD",
            "address_2": "SUITE 2",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320823741",
            "telephone_number": "904-395-3041",
            "fax_number": "904-834-7276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 CANAL BLVD",
            "address_2": "SUITE 2",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320823741",
            "telephone_number": "904-395-3041",
            "fax_number": "904-834-7276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN GRIFFIN, MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-25",
        "last_updated": "2016-01-25",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-395-3041",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME96167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponte Vedra, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.