Lucky Sue Griffin

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

172V00000X Issued in OK

Practice address

620 E Court St
Atoka, OK 74525-3016

Phone

(580) 399-8047

NPI assigned

Jun 20, 2013

Last updated

Jun 20, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371686400000",
    "number": "1558700773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 E COURT ST",
            "city": "ATOKA",
            "state": "OK",
            "postal_code": "745253016",
            "telephone_number": "580-399-8047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 E COURT ST",
            "city": "ATOKA",
            "state": "OK",
            "postal_code": "745253016",
            "telephone_number": "580-399-8047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "LUCKY",
        "middle_name": "SUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-20",
        "last_updated": "2013-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "OK",
            "license": "172V00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community Health Worker in Atoka, OK
• Providers in Atoka, OK by specialty
• Community Health Worker in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2013; 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.