Individual provider Active NPI

Nancy Welch Graf, PA-C

  • Physician Assistant
  • Fayetteville, GA
National Provider Identifier
1043051865
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
12515 Issued in GA
Practice address
101 Yorktown Dr Ste 102
Fayetteville, GA 30214-1578
Phone
(770) 460-4281
NPI assigned
Jun 5, 2024
Last updated
Jan 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 12515 GA Primary

Addresses

Primary practice location

101 Yorktown Dr Ste 102
Fayetteville, GA 30214-1578

Mailing address

101 Yorktown Dr Ste 102
Fayetteville, GA 30214-1578
Phone (770) 460-4281

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250210003504 GA Practitioner - Physician Assistant 3072043736 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group of Georgia LLC CurrentSince Jan 25, 2025 Accepting new patients
Privia Pediatric Medical Group of Georgia LLC Current Accepting new patients

Locations

3715 Northside Pkwy NW
Bldg 100
Atlanta, GA 30327
Phone (770) 680-1473

101 Yorktown Dr
Ste 102
Fayetteville, GA 30214
Phone (770) 460-4281

101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285

Interoperability endpoints

  • Direct secure messaging: nancy.graf.1@8042.direct.athenahealth.com

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1717545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1043051865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 YORKTOWN DR STE 102",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141578",
            "telephone_number": "770-460-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 YORKTOWN DR STE 102",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141578",
            "telephone_number": "770-460-4281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAF",
        "first_name": "NANCY",
        "middle_name": "WELCH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-05",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "12515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.