Kathy Bonita Griggs

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

License

FV0572994 Issued in FL

Practice address

4130 Salisbury Rd
Jacksonville, FL 32216-8031

Phone

(904) 729-9525

NPI assigned

Apr 5, 2021

Last updated

Apr 5, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Be Pampered Foot Spa 1, LLC

  • Clinic/Center
  • Jacksonville, FL
  • NPI 1073397980
  NPD Authorized official

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1750960142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4130 SALISBURY RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168031",
            "telephone_number": "904-729-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 SALISBURY RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322168031",
            "telephone_number": "904-729-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIGGS",
        "first_name": "KATHY",
        "middle_name": "BONITA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-05",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "FL",
            "license": "FV0572994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Marie Griffith, LCSW
• John Daniel Grigas, MD
• Carlie Alexandra Grigg
• Christina Griggs
• Johnel Griggs
• Larissa Lynn Grigsby, LMT
• John P Grim, DDS
• Macy Grim, LPCC
• Frank Grimaldi Jr., PA-C, ATC
• Brian Grimard, MD

• Community Health Worker in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Community Health Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; 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.