Active NPI
Shanta L. Griffin, DPM
- Podiatrist
- Memphis, TN
National Provider Identifier
1588827109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 711
- Practice address
- 1750 Madison Ave
Suite 260
Memphis, TN 38104-6492 - Phone
- (901) 500-5103
- Fax
- (901) 310-9117
- NPI assigned
- Jul 3, 2008
- Last updated
- May 3, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 252 | AR | |
| Podiatrist | 213E00000X | 711 | TN | Primary |
| Foot & Ankle Surgery Podiatrist | 213ES0103X | POD001121 | GA | |
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 711 | TN |
Addresses
Primary practice location
1750 Madison Ave
Suite 260
Memphis, TN 38104-6492
Mailing address
PO Box 21
Southaven, MS 38671-0001
Phone (901) 500-5103
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1521566 | Medicaid | TN | |
| 103I482540 | Other | TN | MEDICARE PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, AR, MS, AL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 4
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- William M. Scholl College of Podiatric Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1750 Madison Ave
Suite 260
Memphis, TN 38104-6458
Phone (901) 500-5103
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 1-10 |
| Removal of nail tissue | 14 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 711 | TN | MD | Specialist |
| 252 | AR | MD | Podiatrist |
| POD001121 | GA | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Total Foot Care, Inc. of Tennessee | Single Specialty | Past | Accepting new patients |
| We Heel the Sole Podiatry LLC | Single Specialty | Past | Accepting new patients |
| Preferred Podiatry Group PC | Single Specialty | Past | Accepting new patients |
Organizations & group practices 6
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.
-
- Primary Podiatric Medicine Podiatrist
- Memphis, TN
- NPI 1497192678
MS
-
- Podiatric Clinic/Center
- Little Rock, AR
- NPI 1730421454
-
- Foot Surgery Podiatrist
- Memphis, TN
- NPI 1518094085
Single Specialty
-
- Primary Podiatric Medicine Podiatrist
- Memphis, TN
- NPI 1558818666
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651536000000",
"number": "1588827109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 21",
"city": "SOUTHAVEN",
"state": "MS",
"postal_code": "386710001",
"telephone_number": "901-500-5103",
"fax_number": "901-310-9117"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1750 MADISON AVE",
"address_2": "SUITE 260",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381046492",
"telephone_number": "901-500-5103",
"fax_number": "901-310-9117"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIFFIN",
"first_name": "SHANTA",
"middle_name": "L.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-03",
"last_updated": "2022-05-03",
"certification_date": "2022-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "AR",
"license": "252",
"primary": false
},
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "TN",
"license": "711",
"primary": true
},
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "GA",
"license": "POD001121",
"primary": false
},
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "TN",
"license": "711",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1521566",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "103I482540",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.