Marley A Griffin Fagg, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

02004405A Issued in IN

Practice address

138 N Dixon Rd
Kokomo, IN 46901

Phone

(765) 236-8282

NPI assigned

Jun 26, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Marley A Griffin Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Internal Medicine

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St Vincent Medical Group IncGroup PAC ID 7012047640, 728 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension at Home Home health agency, Pendleton, IN, CCN 157059
• Elara Caring Home health agency, Kokomo, IN, CCN 157586
• Ascension St Vincent Kokomo Hospital, Kokomo, IN, CCN 150010
• Community Howard Regional Health Inc. Hospital, Kokomo, IN, CCN 150007

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• St. Vincent Medical Group, Inc.

  • Orthopaedic Surgery Physician
  • Winchester, IN
  • NPI 1144513375

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• St Vincent Physician Services Hospital and Health Care Center

  • Family Medicine Physician
  • Indianapolis, IN
  • NPI 1669422234

  Internal Medicine

  Medicare reassignment NPD
• St Vincent Physician Services Hospital and Health Care Center

  • Durable Medical Equipment & Medical Supplies
  • Carmel, IN
  • NPI 1366689044
  NPD
• St. Vincent Medical Group, Inc.

  • Internal Medicine Physician
  • Carmel, IN
  • NPI 1811881527
  NPD
• St Vincent Medical Group Inc

  • Cardiovascular Disease Physician
  • Indianapolis, IN
  • NPI 1558686436
  NPD (past)

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

• Community Home Health Network of Indiana, LLC

  • Home Health Agency
  • Kokomo, IN
  • NPI 1346255940
  Care Compare affiliation
• Community Howard Regional Health, Inc

  • General Acute Care Hospital
  • Kokomo, IN
  • NPI 1902878994
  Care Compare affiliation
• St. Joseph Hospital & Health Center, Inc.

  • General Acute Care Hospital
  • Kokomo, IN
  • NPI 1780625442
  Care Compare affiliation
• St.Vincent Home Health-Anderson, LLC

  • Home Health Agency
  • Pendleton, IN
  • NPI 1942376843
  Care Compare affiliation

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

{
    "created_epoch": "1309046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656028800000",
    "number": "1811283005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 N DIXON RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "469014154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 N DIXON RD",
            "city": "KOKOMO",
            "state": "IN",
            "postal_code": "46901",
            "telephone_number": "765-236-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN FAGG",
        "first_name": "MARLEY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-26",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101019418",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "02004405A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201232310",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "marley.griffin.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St. Vincent Medical Group, Inc.",
            "address_1": "138 N Dixon Rd",
            "city": "Kokomo",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARLEY",
            "last_name": "GRIFFIN",
            "middle_name": "A",
            "prefix": "DR.",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tyra Gregory
• William Robert Grider, DDS
• Mary Lee Grieb, RD
• Lauren Keiko Griebenow, DDS
• Michelle Griesel
• Bradley James Griggs
• Brooklyn Grimes
• Christina R Grimm, NP
• Inna Grishin, DDS
• Jeffrey S Groothuis, MD

• Internal Medicine Physician in Kokomo, IN
• Providers in Kokomo, IN by specialty
• Internal Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.