Micah Griffin, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2019017128 Issued in MO

Practice address

110 Business Park Dr Ste C
Branson, MO 65616-7449

Phone

(417) 336-0033

Fax

(855) 710-6552

NPI assigned

Oct 4, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Micah Miller Or Durbin Former name

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology and Mohs Surgery Skin Cancer CenterGroup PAC ID 8527447945, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Dermatology and Mohs Surgery Skin Cancer Center

  • Dermatology Physician
  • Branson, MO
  • NPI 1124763479
  Medicare reassignment Care Compare group
• Mike Swann, MD, LLC

  • Procedural Dermatology Physician
  • Springfield, MO
  • NPI 1689907081
  NPD (past)

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

{
    "created_epoch": "1570147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1700427358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 BUSINESS PARK DR STE C",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656167449",
            "telephone_number": "417-336-0033",
            "fax_number": "855-710-6552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 BUSINESS PARK DR STE C",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "656167449",
            "telephone_number": "417-336-0033",
            "fax_number": "855-710-6552"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10101 Stoltz Dr",
            "address_purpose": "LOCATION",
            "city": "Rolla",
            "state": "MO",
            "postal_code": "654017714",
            "country_code": "US",
            "telephone_number": "417-336-0033",
            "fax_number": "855-710-6552",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "914 Alexis",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "MO",
            "postal_code": "655366802",
            "country_code": "US",
            "telephone_number": "417-336-0033",
            "fax_number": "855-710-6552",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1230 E Kingsley St Ste A&b",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MO",
            "postal_code": "658047211",
            "country_code": "US",
            "telephone_number": "417-336-0033",
            "fax_number": "855-710-6552",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2200 E Cleveland St",
            "address_purpose": "LOCATION",
            "city": "Monett",
            "state": "MO",
            "postal_code": "657086149",
            "country_code": "US",
            "telephone_number": "417-336-0033",
            "fax_number": "855-710-6552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "MICAH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-04",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2019017128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICAH",
            "last_name": "MILLER OR DURBIN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Mackenzie Ladane Green
• Justin Matthew Gregory, DC
• Allison Jean Griffith, O.D.
• Richard Gene Griffith, MD
• Kathryn L Hackman, FNP
• Arthur E. Hale Jr., MD
• Kimberly K Hale, PT

• Physician Assistant in Branson, MO
• Providers in Branson, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; 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.