John Russell Griggs, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E-15842 Issued in AR

Practice address

3101 SE 14TH St
Bentonville, AR 72712-4900

Phone

(479) 250-1053

Fax

(479) 250-0923

NPI assigned

Jun 15, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mercy Northwest Arkansas Ambulatory Services LLC

  • Urgent Care Clinic/Center
  • Springdale, AR
  • NPI 1366922320

  AR

  Medicare reassignment Care Compare group NPD
• Mercy Health Northwest Arkansas Communities

  • Multi-Specialty Clinic/Center
  • Rogers, AR
  • NPI 1265490916
  NPD (past)

Specialty

Family Practice

Education

Lake Erie College of Osteopathic Medicine, Erie, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Northwest Arkansas Ambulatory Services, LLC 50 clinicians

Practice addresses (Care Compare)

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

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1679954655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 SE 14TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124900",
            "telephone_number": "479-250-1053",
            "fax_number": "479-250-0923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 SE 14TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727124900",
            "telephone_number": "479-250-1053",
            "fax_number": "479-250-0923"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3301 County Road 6 E",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "46514",
            "country_code": "US",
            "telephone_number": "574-266-5342",
            "fax_number": "574-266-5847",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6913 N Main St",
            "address_purpose": "LOCATION",
            "city": "Granger",
            "state": "IN",
            "postal_code": "465308039",
            "country_code": "US",
            "telephone_number": "574-647-1500",
            "fax_number": "574-243-4306",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1815 E Ireland Rd",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466142845",
            "country_code": "US",
            "telephone_number": "574-647-1750",
            "fax_number": "574-647-1748",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "615 N Michigan St Fl 1",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466011033",
            "country_code": "US",
            "telephone_number": "574-647-3050",
            "fax_number": "574-647-1094",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIGGS",
        "first_name": "JOHN",
        "middle_name": "RUSSELL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-15",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02005361A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-15842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300016168",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jgriggs@mybeacon.cernerdirect.com",
            "affiliation": "N",
            "address_1": "6913 N Main St",
            "city": "Granger",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465308039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jessica Greetan
• Gregory Tubre, MD, Apmc
• Marissa Greidanus, PT, DPT
• Hanna C Gresham
• Kristen Griffin
• Cynthia Grimes
• Helen Grimes
• Grove Care LLC
• Maggie B Grymes, OTD
• Laurie Guerrero

• All providers in Bentonville, AR
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; 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.

Verify at the official NPI Registry.