NPIMap

Organization Active NPI

Griffin OBGYN Clinic PA

  • Obstetrics & Gynecology Physician
  • Griffin, GA
National Provider Identifier
1558415919
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
GRIFFIN OBGYN CLINIC PA
Practice address
503 S 8TH Street
Griffin, GA 30224-4211
Phone
(770) 227-5505
Fax
(770) 412-7881
NPI assigned
Jan 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Authorized official

Name
Mrs. Taylor Chastain
Title
Office Manager
Phone
(770) 227-5505

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

503 S 8TH Street
Griffin, GA 30224-4211

Mailing address

503 S 8TH Street
Griffin, GA 30224-4211
Phone (770) 227-5505

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040203000590 GA Part B Supplier - Clinic/Group Practice 6800789041 Receives reassigned benefits from 20 practitioners
Practice locations: Griffin, GA; Thomaston, GA

National Provider Directory

National Provider Directory

Locations

503 S 8th St
Griffin, GA 30224
Phone (770) 227-5505

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13935/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662595200000",
    "number": "1558415919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 S 8TH STREET",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244211",
            "telephone_number": "770-227-5505",
            "fax_number": "770-412-7881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 S 8TH STREET",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244211",
            "telephone_number": "770-227-5505",
            "fax_number": "770-412-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRIFFIN OBGYN CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A",
        "authorized_official_last_name": "CHASTAIN",
        "authorized_official_first_name": "TAYLOR",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-227-5505",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Griffin, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.