Kathleen Graham, AGPCNP-C

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

SP019911 Issued in PA

Practice address

1900 N 9TH St
Philadelphia, PA 19122

Phone

(215) 765-6690

Fax

(215) 765-6694

NPI assigned

Oct 11, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Osh - PA Physicians Group, PCGroup PAC ID 7517213879, 113 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kathleen.graham@oakstreethealth.gwaydirect.com

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.

• Osh - PA Physicians Group, PC

  • Primary Care Clinic/Center
  • Philadelphia, PA
  • NPI 1811405533
  Medicare reassignment Care Compare group NPD
• Public Health Management Corporation

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1881779866
  Medicare reassignment NPD
• Public Health Management Corporation

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1306514138
  NPD
• Public Health Management Corporation

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1467776989
  NPD

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

{
    "created_epoch": "1476144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1043760200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 MARKET ST. WEST TOWER",
            "address_2": "LM 500",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19102",
            "telephone_number": "215-985-2500",
            "fax_number": "267-765-2325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 N 9TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19122",
            "telephone_number": "215-765-6690",
            "fax_number": "215-765-6694"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 9th Ave",
            "address_2": "MailStop G1-MSO",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981012756",
            "country_code": "US",
            "telephone_number": "206-583-6063",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 9th Ave",
            "address_2": "MailStop G1-MSO",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981012756",
            "country_code": "US",
            "telephone_number": "206-583-6063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "KATHLEEN",
        "credential": "AGPCNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-11",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WA",
            "license": "AP60690424",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP019911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Graham
• Diyong S Graham, CRNP
• Erica Michelle Graham, PHARMD
• Erin Graham
• James Jefferson Graham III, D.O.
• Lorelei Graham, CRNP
• Lorraine Graham
• Mark G. Graham, M.D.
• Michaelle Graham, M.A.
• Miranda Lynne Graham, PHARMD

• Gerontology Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Gerontology Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.