Individual provider Active NPI

Blake Katharine Griffitts, PA

  • Physician Assistant
  • Dover, DE
National Provider Identifier
1942815568
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
640 S State St
Dover, DE 19901-3530
Phone
(302) 744-7121
NPI assigned
Sep 10, 2020
Last updated
Oct 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X DE Primary

Addresses

Primary practice location

640 S State St
Dover, DE 19901-3530

Mailing address

640 S. State Street
Mail Code 3055
Dover, DE 19901-3530
Phone (302) 480-1688

Other practice location 1

401 N Carter Rd Ste 101
Smyrna, DE 19977-1281
Phone (302) 659-2190

Other practice location 2

100 Wellness Way
Milford, DE 19963-4364
Phone (302) 422-3311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201123001024 DE Practitioner - Physician Assistant 5092126144 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bayhealth Medical Center, Inc CurrentSince Oct 27, 2020 Accepting new patients
Bayhealth Medical Center, Inc. CurrentSince Oct 27, 2020 Accepting new patients
Bayhealth Medical Center, Inc. CurrentSince Oct 27, 2020 Accepting new patients

Locations

640 S State St
Dover, DE 19901
Phone (302) 744-4700

640 S State St
#3055
Dover, DE 19901
Phone (302) 480-1688

100 Wellness Way
Milford, DE 19963
Phone (302) 422-3311

401 N Carter Rd
Ste 101
Smyrna, DE 19977
Phone (302) 659-2190

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1942815568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 S. STATE STREET",
            "address_2": "MAIL CODE 3055",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013530",
            "telephone_number": "302-480-1688",
            "fax_number": "302-480-9807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 S STATE ST",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199013530",
            "telephone_number": "302-744-7121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 N Carter Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Smyrna",
            "state": "DE",
            "postal_code": "199771281",
            "country_code": "US",
            "telephone_number": "302-659-2190",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Wellness Way",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "DE",
            "postal_code": "199634364",
            "country_code": "US",
            "telephone_number": "302-422-3311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIFFITTS",
        "first_name": "BLAKE",
        "middle_name": "KATHARINE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-10",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

Verify at the official NPI Registry.