Individual provider Active NPI

Clint Griffin, M.D.

  • Emergency Medicine Physician
  • Holland, MI
National Provider Identifier
1841350808
Registry record updated Jul 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4301073590 Issued in MI
Practice address
602 Michigan Ave
Holland, MI 49423-4918
Phone
(616) 394-3205
NPI assigned
Dec 11, 2006
Last updated
Jul 28, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301073590 MI Primary

Addresses

Primary practice location

602 Michigan Ave
Holland, MI 49423-4918

Mailing address

PO Box 30516
Dept. 4006
Lansing, MI 48909-8016
Phone (616) 975-1845

Other identifiers 1

IdentifierTypeStateIssuer
930096829OtherMIRAIL ROAD MEDICARE

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20070625000069 MI Practitioner - Emergency Medicine 3072612530 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Louisiana State University School of Medicine in New Orleans, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Epi PCGroup PAC ID 0941293302, 16 clinicians

Practice addresses (Care Compare)

602 Michigan Ave
Holland, MI 49423-4918
Phone (616) 392-5141

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Epi PC Emergency Medicine CurrentSince Jul 1, 1999 Accepting new patients
Holland Community Hospital Current Accepting new patients
Holland Community Hospital CurrentSince Nov 1, 2020 Accepting new patients
Holland Community Hospital CurrentSince Nov 1, 2020 Accepting new patients

Locations

15100 Whittaker Way
Grand Haven, MI 49417
Phone (616) 935-6200

3232 N Wellness Dr
Holland, MI 49424
Phone (616) 494-4250

602 Michigan Ave
Holland, MI 49423
Phone (616) 394-3350

Interoperability endpoints

  • Direct secure messaging: clinton.griffin.1@31044.direct.athenahealth.com

Organizations & group practices 4

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 1

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": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248739200000",
    "number": "1841350808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30516",
            "address_2": "DEPT. 4006",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489098016",
            "telephone_number": "616-975-1845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 MICHIGAN AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494234918",
            "telephone_number": "616-394-3205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "CLINT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2009-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301073590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "930096829",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.