Individual provider Active NPI

Nicole Ashley Griffin, DO

  • Student in an Organized Health Care Education/Training Program
  • Canton, OH
National Provider Identifier
1679327332
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
58.034291 Issued in OH
Practice address
2600 Sixth St SW
Canton, OH 44710-1702
Phone
(330) 837-8391
Fax
(330) 837-6782
NPI assigned
Apr 17, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 58.034291 OH Primary

Addresses

Primary practice location

2600 Sixth St SW
Canton, OH 44710-1702

Mailing address

2600 Sixth St SW
Canton, OH 44710-1702
Phone (330) 837-8391

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241002001220 OH Order and Referring Only - Orthopedic SurgeryPractitioner - Orthopedic Surgery 4082145032

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
58.034291OHMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1713312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1679327332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 SIXTH ST SW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447101702",
            "telephone_number": "330-837-8391",
            "fax_number": "330-837-6782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 SIXTH ST SW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447101702",
            "telephone_number": "330-837-8391",
            "fax_number": "330-837-6782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "NICOLE",
        "middle_name": "ASHLEY",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-17",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "58.034291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.