Individual provider Active NPI

Christopher Griffin, PTA

  • Physical Therapy Assistant
  • Jacksonville, FL
National Provider Identifier
1770356222
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA30317 Issued in FL
Practice address
6144 Gazebo Park PL S Ste 101
Jacksonville, FL 32257-1086
Phone
(904) 260-3011
Fax
(904) 260-4849
NPI assigned
Nov 6, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA30317 FL Primary

Addresses

Primary practice location

6144 Gazebo Park PL S Ste 101
Jacksonville, FL 32257-1086

Mailing address

6144 Gazebo Park PL S Ste 101
Jacksonville, FL 32257-1086
Phone (904) 260-3011

Other practice location 1

1409 Kingsley Ave Bldg 3
Orange Park, FL 32073-4537
Phone (904) 260-3011

Other practice location 2

2425 Dunn Ave Ste 1
Jacksonville, FL 32218-4603
Phone (904) 260-3011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTA30317FLMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Occupational and Rehabilitation Center PA CurrentSince Nov 12, 2023 Accepting new patients
Integra Therapeutic Massage, LLC PastSince Nov 12, 2023 Accepting new patients

Locations

6144 Gazebo Park Pl S
Ste 101
Jacksonville, FL 32257
Phone (904) 260-3011

2425 Dunn Ave
#1
Jacksonville, FL 32218
Phone (904) 260-3011

1409 Kingsley Ave
Bldg 3
Orange Park, FL 32073
Phone (904) 260-3011

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1770356222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6144 GAZEBO PARK PL S STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322571086",
            "telephone_number": "904-260-3011",
            "fax_number": "904-260-4849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6144 GAZEBO PARK PL S STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322571086",
            "telephone_number": "904-260-3011",
            "fax_number": "904-260-4849"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1409 Kingsley Ave Bldg 3",
            "address_purpose": "LOCATION",
            "city": "Orange Park",
            "state": "FL",
            "postal_code": "320734537",
            "country_code": "US",
            "telephone_number": "904-260-3011",
            "fax_number": "904-260-4849",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2425 Dunn Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322184603",
            "country_code": "US",
            "telephone_number": "904-260-3011",
            "fax_number": "904-260-4849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "CHRISTOPHER",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA30317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.