Active NPI
Mary Lynn Griswold, ED D
- Psychologist
- Cincinnati, OH
National Provider Identifier
1609980630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 3865
- Practice address
- 3185 Dot Drive
Cincinnati, OH 45213 - Phone
- (513) 984-8636
- NPI assigned
- Aug 18, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 3865 | OH | Primary |
Addresses
Primary practice location
3185 Dot Drive
Cincinnati, OH 45213
Mailing address
3185 Dot Drive
Cincinnati, OH 45213
Phone (513) 984-8636
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000031401 | Other | ANTHEM BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20091019000296 | OH | Practitioner - Clinical Psychologist | 8729125000 | Practice locations: Cincinnati, OH |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- University of Cincinnati College of Medicine, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
3185 Dot Dr
Cincinnati, OH 45213-1007
Phone (513) 984-8636
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3865 | OH | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609980630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3185 DOT DRIVE",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "45213",
"telephone_number": "513-984-8636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3185 DOT DRIVE",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "45213",
"telephone_number": "513-984-8636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRISWOLD",
"first_name": "MARY LYNN",
"name_prefix": "Dr.",
"credential": "ED D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OH",
"license": "3865",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS",
"identifier": "000000031401",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.