Individual provider Active NPI

Autumn Dawn Griffin, OTR/L

  • Occupational Therapist
  • Cordele, GA
National Provider Identifier
1689865057
Registry record updated Aug 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
004054 Issued in GA
Practice address
307 E 3Rd Ave
Cordele, GA 31015-3208
Phone
(229) 271-4612
Fax
(229) 271-4616
NPI assigned
Aug 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 004054 GA Primary

Addresses

Primary practice location

307 E 3Rd Ave
Cordele, GA 31015-3208

Mailing address

307 E 3Rd Ave
Cordele, GA 31015
Phone (229) 271-4612

Other identifiers 1

IdentifierTypeStateIssuer
004054OtherGAOT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100218000071 GA Practitioner - Occupational Therapist in Private Practice 0840334694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Medical College of Georgia School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tift Regional Health System IncGroup PAC ID 2062745169, 294 clinicians

Practice addresses (Care Compare)

2227 US Hwy 41 N
Tifton, GA 31794-2749
Phone (229) 353-6188

Merit-based Incentive Payment System (MIPS)

Final score
81.02 of 100Reported as group
Quality
57.87
Promoting interoperability
100
Improvement activities
40
Cost
75.97

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004054GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tift Regional Health System Inc CurrentSince Jun 1, 2018 Accepting new patients
Tift Regional Health System Inc CurrentSince Aug 1, 2019 Accepting new patients
Tift Regional Health System Inc CurrentSince Jun 1, 2018 Accepting new patients
Tift Regional Health System Inc Current Accepting new patients
Crisp Regional Hospital Inc Past Accepting new patients

Locations

2227 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-6188

1610 John Orr Dr
Ste A
Tifton, GA 31794
Phone (229) 386-5222

2225 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-3422

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1186617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186617600000",
    "number": "1689865057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 E 3RD AVE",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "31015",
            "telephone_number": "229-271-4612",
            "fax_number": "229-271-4616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 E 3RD AVE",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310153208",
            "telephone_number": "229-271-4612",
            "fax_number": "229-271-4616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "AUTUMN",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-09",
        "last_updated": "2007-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "004054",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OT",
            "identifier": "004054",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cordele, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.