Elysa C. Graham, DNP, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5009266 Issued in NC

Practice address

1914 J N Pease PL Ste 144
Charlotte, NC 28262-4504

Phone

(704) 412-2802

Fax

(336) 203-2092

NPI assigned

Jan 12, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Mrs. Elysa C. Kerr Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: elysa.graham.1@18423.direct.athenahealth.com

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

{
    "created_epoch": "1452556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1174989792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9311 JW CLAY BLVD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282625411",
            "telephone_number": "704-412-2802",
            "fax_number": "336-203-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1914 J N PEASE PL STE 144",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282624504",
            "telephone_number": "704-412-2802",
            "fax_number": "336-203-2092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "ELYSA",
        "middle_name": "C.",
        "name_prefix": "Mrs.",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-12",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NC",
            "license": "5009266",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NC",
            "license": "5009266",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5009266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELYSA",
            "last_name": "KERR",
            "middle_name": "C.",
            "prefix": "MRS.",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Danielle Leigh Graham, PHD
• David Lee Graham, MD
• Desiree Elaine Graham, LCMHCA
• Donnetta Lafaye Graham, MSW, LCSW
• Elizabeth Renee Graham
• Erin Elizabeth Graham, CNM
• Ethan P Graham
• Gloria Ann Graham, OTR
• Heather Graham, M.D.
• Jada Renae Graham, DDS

• Family Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.