Bethany Anne Graham, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NP11740 Issued in OH

Practice address

1250 Ralston Ave
Suite 204
Defiance, OH 43512-5311

Phone

(419) 782-8332

Fax

(419) 782-6855

NPI assigned

Sep 8, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Promedica Defiance Regional Hospital Hospital, Defiance, OH, CCN 361328
• Promedica Toledo Hospital Hospital, Toledo, OH, CCN 360068

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bgraham16473@direct.promedica.org

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.

• Promedica Central Physicians

  • Family Medicine Physician
  • Toledo, OH
  • NPI 1043270150

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Promedica Central Physicians

  • Durable Medical Equipment & Medical Supplies
  • Toledo, OH
  • NPI 1669068482
  NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Defiance Hospital Inc.

  • Critical Access Hospital
  • Defiance, OH
  • NPI 1699775726
  Care Compare affiliation
• The Toledo Hospital

  • General Acute Care Hospital
  • Toledo, OH
  • NPI 1407854771
  Care Compare affiliation
• Toledo Hospital

  • Ambulance
  • Toledo, OH
  • NPI 1427147339

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1225345549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 RALSTON AVE",
            "address_2": "SUITE 204",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435125311",
            "telephone_number": "419-782-8332",
            "fax_number": "419-782-6855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 RALSTON AVE",
            "address_2": "SUITE 204",
            "city": "DEFIANCE",
            "state": "OH",
            "postal_code": "435125311",
            "telephone_number": "419-782-8332",
            "fax_number": "419-782-6855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "BETHANY",
        "middle_name": "ANNE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-08",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "NP11740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "GRNP37611",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3093558",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bgraham16473@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Theresa Ann Goebel, LPN
• Rachanda Goings, LPN
• Misty Gomez
• Brittany Nicole Gonterman
• Karan Gottwald, LMT
• Christina Grant
• Earl B Grant
• Sonia R Gray, PTA
• Holly A Greear, LPN
• Ericha Griep

• Nurse Practitioner in Defiance, OH
• Providers in Defiance, OH by specialty
• Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.