Individual provider Active NPI

Jordan H Grizzle, MD

  • Family Medicine Physician
  • Blairsville, GA
National Provider Identifier
1861134967
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
98769 Issued in GA
Practice address
346 Deep South Farm Rd Ste a
Blairsville, GA 30512-2218
Phone
(706) 745-9417
Fax
(706) 896-0877
NPI assigned
Apr 9, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 98769 GA Primary

Addresses

Primary practice location

346 Deep South Farm Rd Ste a
Blairsville, GA 30512-2218

Mailing address

346 Deep South Farm Rd Ste a
Blairsville, GA 30512-2218
Phone (706) 745-9417

Other practice location 1

4799 Blue Ridge Dr Ste 104
Blue Ridge, GA 30513-3468
Phone (706) 632-1155

Other practice location 2

304 Shorter Ave NW Ste 201
Rome, GA 30165-4256
Phone (706) 509-3300

Other identifiers 1

IdentifierTypeStateIssuer
003279288CMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20240726003980 GA Practitioner - Family Practice 7214473198 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Georgia Medicine LLCGroup PAC ID 6406923739, 16 clinicians

Practice addresses (Care Compare)

346 Deep S Farm Rd
Suite a
Blairsville, GA 30512-2218
Phone (706) 745-9417

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
98769GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Georgia Medicine LLC Family Medicine CurrentSince Jul 1, 2024 Accepting new patients

Locations

346 Deep South Farm Rd
#A
Blairsville, GA 30512
Phone (706) 745-9417

4799 Blue Ridge Dr
Ste 104
Blue Ridge, GA 30513
Phone (706) 492-3200

Organizations & group practices 1

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.

Hospital & facility affiliations 5

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": "1649462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1861134967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 DEEP SOUTH FARM RD STE A",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305122218",
            "telephone_number": "706-745-9417",
            "fax_number": "706-896-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "346 DEEP SOUTH FARM RD STE A",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305122218",
            "telephone_number": "706-745-9417",
            "fax_number": "706-896-0877"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4799 Blue Ridge Dr Ste 104",
            "address_purpose": "LOCATION",
            "city": "Blue Ridge",
            "state": "GA",
            "postal_code": "305133468",
            "country_code": "US",
            "telephone_number": "706-632-1155",
            "fax_number": "706-896-0877",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "304 Shorter Ave NW Ste 201",
            "address_purpose": "LOCATION",
            "city": "Rome",
            "state": "GA",
            "postal_code": "301654256",
            "country_code": "US",
            "telephone_number": "706-509-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIZZLE",
        "first_name": "JORDAN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-09",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "98769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003279288C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blairsville, GA

Sources for this page

Verify at the official NPI Registry.