Individual provider Active NPI

Jack Griffeth, M.D.

  • Radiation Oncology Physician
  • Gainesville, GA
National Provider Identifier
1548262561
Registry record updated Jan 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
027819 Issued in GA
Practice address
743 Spring St NE
Gainesville, GA 30501-3715
Phone
(770) 219-1824
Fax
(770) 219-7787
NPI assigned
Aug 10, 2005
Last updated
Jan 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 027819 GA Primary

Addresses

Primary practice location

743 Spring St NE
Gainesville, GA 30501-3715

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other identifiers 1

IdentifierTypeStateIssuer
00602621AMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jgriffeth29468@nghs.gadirect.net Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080410000056 GA Practitioner - Radiation Oncology 1658458070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Medical College of Georgia School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

597 S Enota Dr NE
Gainesville, GA 30501-2545
Phone (770) 219-7777

743 Spring Nest
Gainesville, GA 30501-3715
Phone (770) 219-6000

743 Spring St NE
Gainesville, GA 30501-3715

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.83 of 100Reported as group
Quality
80.36
Promoting interoperability
100
Improvement activities
40
Cost
79.08

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
027819GAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Physicians Group Inc CurrentSince Sep 1, 2014 Accepting new patients

Locations

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

Interoperability endpoints

  • Direct secure messaging: jgriffeth29468@nghs.gadirect.net

Organizations & group practices 1

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": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1548262561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 SPRING ST NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013715",
            "telephone_number": "770-219-1824",
            "fax_number": "770-219-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFETH",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "GA",
            "license": "027819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00602621A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgriffeth29468@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "743 Spring St NE",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305013715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.