MEDICARE: DR. JOHN M. GRIGGS DNP, FNP-C, CDCES

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
1	163WD0400X	Diabetes Educator Registered Nurse	1947622	FL
2	363LF0000X	Family Nurse Practitioner	APRN11014716	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00625822	OTHER	FL	MEDICARE RAIL ROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750384012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN M. GRIGGS DNP, FNP-C, CDCES

Provider Business Mailing Address
First Line	:	3801 E HIGHWAY 98
Second Line	:
City	:	PORT ST JOE
State	:	FL
Zip	:	32456-5318
Country	:	US
Telephone Number	:	850-229-5601
Fax Number	:	850-229-5609

Provider Business Practice Location Address
First Line	:	3801 E HIGHWAY 98
Second Line	:
City	:	PORT ST JOE
State	:	FL
Zip	:	32456-5318
Country	:	US
Telephone Number	:	850-568-1053
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	05/26/2023

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