Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Johnnie R Degraw Inc

Organization Family Medicine Physician · NPI 1700109915

Johnnie R Degraw Inc is a Family Medicine Physician in Crystal River, Florida. Licensed in Florida. Registered with an NPI since 2010.

Licensed in
FL
In the registry since
2010
Specialties on file
3
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5915 W Gulf To Lake Hwy
Crystal River, FL 34429-7565
Phone: (352) 794-3872
Fax: (352) 794-3876
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA2646 (FL)
Adult Health Nurse Practitioner Taxonomy 363LA2200X

Record details

NPI number1700109915
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Johnnie Degraw — Owner · (352) 794-3872
NPI enumeratedMarch 3, 2010
Last updated in NPPESOctober 1, 2020
Certification dateOctober 1, 2020
Mailing address5915 W Gulf To Lake Hwy, Crystal River, FL 34429-7565

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