Johnnie R Degraw Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

JOHNNIE R DEGRAW INC

Practice address

5915 W Gulf to Lake Hwy
Crystal River, FL 34429-7565

Phone

(352) 794-3872

Fax

(352) 794-3876

NPI assigned

Mar 3, 2010

Organization subpart

No

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

Authorized official

Name

Johnnie R Degraw, MD

Title

Owner

Phone

(352) 794-3872

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1267574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601510400000",
    "number": "1700109915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5915 W GULF TO LAKE HWY",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344297565",
            "telephone_number": "352-794-3872",
            "fax_number": "352-794-3876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5915 W GULF TO LAKE HWY",
            "city": "CRYSTAL RIVER",
            "state": "FL",
            "postal_code": "344297565",
            "telephone_number": "352-794-3872",
            "fax_number": "352-794-3876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNNIE R DEGRAW INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-03",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A",
        "authorized_official_last_name": "DEGRAW",
        "authorized_official_first_name": "JOHNNIE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-794-3872",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA2646",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• John W Grace MD PA
• Renee Johnson, ARNP
• Susan Johnston, PHYSICAL THERAPIST
• Andrew J Jones, D.C.
• Jodi M Jordan, LCSW
• Jorge Ruiz Llanes MD PA

• Family Medicine Physician in Crystal River, FL
• Providers in Crystal River, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.