Individual provider Active NPI

Holly Kendall Griffith, P.A.

  • Physician Assistant
  • Lauderdale Lakes, FL
National Provider Identifier
1750639209
Registry record updated Aug 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9106171 Issued in FL
Practice address
4850 W Oakland Park Blvd
Suite 143
Lauderdale Lakes, FL 33313-7260
Phone
(954) 676-9980
Fax
(954) 676-5288
NPI assigned
Aug 15, 2012
Last updated
Aug 15, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9106171 FL Primary

Addresses

Primary practice location

4850 W Oakland Park Blvd
Suite 143
Lauderdale Lakes, FL 33313-7260

Mailing address

4850 W Oakland Park Blvd
Suite 203
Lauderdale Lakes, FL 33313-7260
Phone (954) 484-7030

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20130328000311 FL Practitioner - Physician Assistant 4385889021 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holy Cross Hospital IncGroup PAC ID 1850298365, 299 clinicians

Practice addresses (Care Compare)

1309 S Federal Hwy
Holy Cross Medical Group
Fort Lauderdale, FL 33316-2040
Phone (954) 463-4383

4725 N Fed Hwy
Ft. Lauderdale, FL 33308-4603
Phone (954) 771-8000

4725 N Federal Hwy
Fort Lauderdale, FL 33308-4603
Phone (954) 542-6000

4725 N Federal Hwy 201
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 565-5807

4725 N Federal Hwy 302
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 351-5931

4725 N Federal Hwy 401
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 772-2136

4725 N Federal Hwy 501
Holy Cross Medical Group
Fort Lauderdale, FL 33308-4603
Phone (954) 351-7770

4725 N Federal Hwy 504
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 414-9750

4725 N Federal Hwy Cancer Ctr
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 267-7700

4725 N Federal Hwy HCMG Multispecialty
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 267-6770

4725 N Federal Hwy Neuro Radiology
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 492-5780

4725 N Federal Hwy Nuclear Medicine
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 492-5748

4725 N Federal Hwy Pathology Departmen
Holy Cross Medical Group
Ft Lauderdale, FL 33308-4603
Phone (954) 492-5728

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9106171FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Holy Cross Hospital, Inc CurrentSince Jun 9, 2015 Accepting new patients

Locations

1309 S Federal Hwy
#G
Ft Lauderdale, FL 33316
Phone (954) 463-4383

Interoperability endpoints

  • Direct secure messaging: hgriffithhanna2017960@direct.trinity-health.org

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": "1344988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344988800000",
    "number": "1750639209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 W OAKLAND PARK BLVD",
            "address_2": "SUITE 203",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333137260",
            "telephone_number": "954-484-7030",
            "fax_number": "954-484-1280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 W OAKLAND PARK BLVD",
            "address_2": "SUITE 143",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333137260",
            "telephone_number": "954-676-9980",
            "fax_number": "954-676-5288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFITH",
        "first_name": "HOLLY",
        "middle_name": "KENDALL",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-15",
        "last_updated": "2012-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderdale Lakes, FL

Sources for this page

Verify at the official NPI Registry.