NPIMap

Individual provider Active NPI

Susannah Graham, PA-C

  • Physician Assistant
  • Florence, SC
National Provider Identifier
1003562554
Registry record updated Mar 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4342 Issued in SC
Practice address
805 Pamplico Hwy
Florence, SC 29505-6047
Phone
(843) 792-1414
NPI assigned
Feb 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 4342 SC Primary
Medical Physician Assistant 363AM0700X
Surgical Physician Assistant 363AS0400X

Addresses

Primary practice location

805 Pamplico Hwy
Florence, SC 29505-6047

Mailing address

PO Box 935722
Atlanta, GA 31193-5722
Phone (843) 792-6200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.musc.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220331000969 SC Practitioner - Physician Assistant 9234525270 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians

Practice addresses (Care Compare)

1580 Freedom Blvd
Florence, SC 29505-6074

506 N St
Bamberg, SC 29003-1319
Phone (803) 245-6290

805 Pamplico Hwy
Florence, SC 29505-6047

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
80.41 of 100Reported as group
Quality
64.93
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4342SCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Musc Community Physicians CurrentSince Mar 9, 2022 Accepting new patients
Musc Community Physicians CurrentSince Mar 9, 2022 Accepting new patients

Locations

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

805 Pamplico Hwy
Florence, SC 29505
Phone (843) 674-2500

Interoperability endpoints

  • Direct secure messaging: sgraham352565@direct.musc.edu

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1003562554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 935722",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311935722",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 PAMPLICO HWY",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295056047",
            "telephone_number": "843-792-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "SUSANNAH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-23",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "4342",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "805 Pamplico Hwy",
            "city": "Florence",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295056047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

Verify at the official NPI Registry.