Adrienne Lisa Graham, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11010827 Issued in FL

Practice address

21758 State Road 54
Lutz, FL 33549-6921

Phone

(813) 563-6070

Fax

(813) 563-6040

NPI assigned

Jan 13, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Practice roles

Locations

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.

• Sandhill Pediatrics, P.a.

  • Pediatrics Physician
  • Lutz, FL
  • NPI 1902302748
  NPD

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

{
    "created_epoch": "1610496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1184213167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21758 STATE ROAD 54",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335496921",
            "telephone_number": "813-563-6070",
            "fax_number": "813-563-6040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21758 STATE ROAD 54",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335496921",
            "telephone_number": "813-563-6070",
            "fax_number": "813-563-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "ADRIENNE",
        "middle_name": "LISA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-13",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11010827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Lutz",
            "affiliation": "Y",
            "affiliationName": "Sandhill Pediatrics, P.A.",
            "address_1": "21758 State Road 54",
            "city": "Lutz",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335496921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Natalie Gordon, LCSW
• Altinai Gorrity, DDS
• Julie Marie Gorski
• Rama Rai Gosine, CRNA
• Allison Grabowski
• Bernadette Graham
• Grand Oaks Massage Inc
• Grandbrook Home Care Facility
• John Granone, D.C.
• Scott Gray

• Family Nurse Practitioner in Lutz, FL
• Providers in Lutz, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; 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.