Provider Demographics
NPI:1114936606
Name:GRIGGS, JAMES PHILIP JR (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:PHILIP
Last Name:GRIGGS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12016 LEMMOND FARM DR
Practice Address - Street 2:STE 100
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-8353
Practice Address - Country:US
Practice Address - Phone:704-863-9615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC35653207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8937593Medicaid
NC37593OtherBLUE CROSS BLUE SHIELD
SCNC2521Medicaid
NC1114936606Medicaid
NC2189019BMedicare PIN
F61129Medicare UPIN
NCNC3086BMedicare PIN
SCNC2521Medicaid
NCNC3086DMedicare PIN
NCNC3086CMedicare PIN
NC1114936606Medicaid
NCNC3086EMedicare PIN