Organization Active NPI

Walter G Griffith Jr MD PA

  • Psychiatry Physician
  • St Petersburg, FL
National Provider Identifier
1578675534
Registry record updated Jan 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME61913 Issued in FL
Legal business name
WALTER G GRIFFITH JR MD PA
Practice address
5565 Dr Martin Luther King Jr St N
St Petersburg, FL 33703-1203
Phone
(727) 577-1203
Fax
(727) 577-0983
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2014

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

Authorized official

Name
Walther G Griffith Jr., M.D.
Title
Owner
Phone
(727) 577-1203

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X ME61913 FL Primary

Addresses

Primary practice location

5565 Dr Martin Luther King Jr St N
St Petersburg, FL 33703-1203

Mailing address

PO Box 55156
St Petersburg, FL 33732-5156
Phone (727) 577-1203

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081010000445 FL Part B Supplier - Clinic/Group Practice 9537237029 Receives reassigned benefits from 7 practitioners
Practice locations: St Petersburg, FL

National Provider Directory

National Provider Directory

Locations

2555 Enterprise Rd
Ste 12
Clearwater, FL 33763
Phone (727) 496-2560

8916 77th Ter E
Unit 105
Lakewood Ranch, FL 34202
Phone (941) 999-2112

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389571200000",
    "number": "1578675534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55156",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337325156",
            "telephone_number": "727-577-1203",
            "fax_number": "727-577-0983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5565 DR MARTIN LUTHER KING JR ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337031203",
            "telephone_number": "727-577-1203",
            "fax_number": "727-577-0983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTER G GRIFFITH JR MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2014-01-13",
        "status": "A",
        "authorized_official_last_name": "GRIFFITH",
        "authorized_official_first_name": "WALTHER",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-577-1203",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME61913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2014; 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.