Ivan Everette Griggs, PHARM.D.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PS57639 Issued in FL

Practice address

13711 S Tamiami TRL
Fort Myers, FL 33912-1649

Phone

(850) 305-1293

NPI assigned

Nov 22, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1606003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606003200000",
    "number": "1780288654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4903 EDITH ESPLANADE",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339045617",
            "telephone_number": "850-305-1293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13711 S TAMIAMI TRL",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339121649",
            "telephone_number": "850-305-1293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIGGS",
        "first_name": "IVAN",
        "middle_name": "EVERETTE",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-22",
        "last_updated": "2020-11-22",
        "certification_date": "2020-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "FL",
            "license": "PS57639",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PS57639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Joseph Griffith, DMD
• Whitney Griffith
• Darlajean Marie Griffiths, L.M.T
• Michael David Griffiths, OTR
• Sarah Rebekah Grigg, MT-BC
• Joseph Grillo, DPM
• Gregory James Grimes, DNAP, CRNA, APRN
• Holly Lynn Grimes, APRN
• Lauren Grimes, PHARMD
• Anne Marie Grimmer

• Community/Retail Pharmacy in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2020; 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.