Individual provider Active NPI

Georgia Griffin, D.O.

  • Neuromusculoskeletal Medicine & OMM Physician
  • Mount Clemens, MI
National Provider Identifier
1720037708
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
5101016677 Issued in MI
Practice address
1030 Harrington Blvd.
Ste. 206
Mt. Clemens, MI 48043-2967
Phone
(586) 493-3260
Fax
(586) 493-3265
NPI assigned
May 8, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X 5101016677 MI Primary

Addresses

Primary practice location

1030 Harrington Blvd.
Ste. 206
Mt. Clemens, MI 48043-2967

Mailing address

1030 Harrington Blvd.
Ste. 206
Mt. Clemens, MI 48043-2967
Phone (586) 493-3260

Other identifiers 1

IdentifierTypeStateIssuer
4805484MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20051230000624 MI Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 6406878651 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Midwestern University, Chicago College of Osteopathic Med, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren MacombGroup PAC ID 8921912791, 131 clinicians

Practice addresses (Care Compare)

1030 Harrington St
Mount Clemens, MI 48043-2967

1030 Harrington St
Suite Ll001
Mount Clemens, MI 48043-2918
Phone (586) 493-3297

37399 Garfield Rd
Clinton Township, MI 48036-3672

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Macomb Past Accepting new patients

Organizations & group practices 2

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

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1720037708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 HARRINGTON BLVD.",
            "address_2": "STE. 206",
            "city": "MT. CLEMENS",
            "state": "MI",
            "postal_code": "480432967",
            "telephone_number": "586-493-3260",
            "fax_number": "586-493-3265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 HARRINGTON BLVD.",
            "address_2": "STE. 206",
            "city": "MT. CLEMENS",
            "state": "MI",
            "postal_code": "480432967",
            "telephone_number": "586-493-3260",
            "fax_number": "586-493-3265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "GEORGIA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "MI",
            "license": "5101016677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4805484",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Clemens, MI

Sources for this page

Verify at the official NPI Registry.