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NPI Code Detail

MEDICARE: JONATHAN GRIFFIN II

MEDICARE: JONATHAN GRIFFIN II
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator
2376J00000XHomemaker
3172A00000XDriver
4251B00000XCase Management Agency
5251E00000XHome Health Agency
6171400000XHealth & Wellness Coach

General Provider Information

NPI Number : 1477358729
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN GRIFFIN II
Provider Business Mailing Address
First Line : 486 NORWOOD AVE
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44504-1549
Country : US
Telephone Number : 330-423-3414
Fax Number :
Provider Business Practice Location Address
First Line : 486 NORWOOD AVE
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44504-1549
Country : US
Telephone Number : 330-423-3414
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2025
Last Update Date : 05/22/2025

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