Individual provider Active NPI

Ellie Anna Griffin, DO

  • Ophthalmology Physician
  • Bellingham, WA
National Provider Identifier
1891765616
Registry record updated Mar 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
OP00002031 Issued in WA
Practice address
4540 Cordata Pkwy
Suite 103
Bellingham, WA 98226-8059
Phone
(360) 676-8663
Fax
(360) 676-8682
NPI assigned
Jan 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X OP00002031 WA Primary

Addresses

Primary practice location

4540 Cordata Pkwy
Suite 103
Bellingham, WA 98226-8059

Mailing address

4540 Cordata Pkwy
Suite 103
Bellingham, WA 98226-8059
Phone (360) 676-8663

Other identifiers 4

IdentifierTypeStateIssuer
0046298OtherL&I
7063910MedicaidWA
199938OtherL&I
8432817MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20050912000187 WA Practitioner - Osteopathic Manipulative MedicinePractitioner - Family PracticePractitioner - Other (Physician)Practitioner - Ophthalmology 3375576382 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative MedicineAlso: Ophthalmology
Education
University of North Texas HSC, College of Osteopathic Med, 1991
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1317 23Rd St
Bellingham, WA 98225-7231
Phone (360) 733-1407

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ellie Griffin DO PS Ophthalmology CurrentSince Oct 27, 2008 Accepting new patients
Oregon Anesthesiology Group PC Past Accepting new patients

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": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268870400000",
    "number": "1891765616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4540 CORDATA PKWY",
            "address_2": "SUITE 103",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982268059",
            "telephone_number": "360-676-8663",
            "fax_number": "360-676-8682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4540 CORDATA PKWY",
            "address_2": "SUITE 103",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982268059",
            "telephone_number": "360-676-8663",
            "fax_number": "360-676-8682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "ELLIE",
        "middle_name": "ANNA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-24",
        "last_updated": "2010-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "WA",
            "license": "OP00002031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0046298",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7063910",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "199938",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8432817",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.