Individual provider Active NPI

Paulina Graham

  • Occupational Therapist
  • Tega Cay, SC
National Provider Identifier
1104367291
Registry record updated Mar 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
4912 Issued in SC
Practice address
111 Wellmore Dr
Tega Cay, SC 29708-0124
Phone
(803) 835-7026
NPI assigned
Mar 9, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 4912 SC Primary

Addresses

Primary practice location

111 Wellmore Dr
Tega Cay, SC 29708-0124

Mailing address

111 Wellmore Dr
Tega Cay, SC 29708-0124
Phone (803) 835-7026

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1489017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489017600000",
    "number": "1104367291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 WELLMORE DR",
            "city": "TEGA CAY",
            "state": "SC",
            "postal_code": "297080124",
            "telephone_number": "803-835-7026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 WELLMORE DR",
            "city": "TEGA CAY",
            "state": "SC",
            "postal_code": "297080124",
            "telephone_number": "803-835-7026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "PAULINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-09",
        "last_updated": "2017-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "4912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tega Cay, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.