Individual provider Active NPI

Linda Kelly Graves, NP

  • Ambulatory Women's Health Care Registered Nurse
  • King of Prussia, PA
National Provider Identifier
1225695331
Registry record updated May 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Women's Health Care Registered NurseTaxonomy code 163WW0101X
License
RN225600L Issued in PA
Practice address
625 Clark Ave Ste 17B
King of Prussia, PA 19406-1438
Phone
(215) 654-1544
Fax
(215) 654-1543
NPI assigned
May 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Women's Health Care Registered Nurse 163WW0101X RN225600L PA Primary

Addresses

Primary practice location

625 Clark Ave Ste 17B
King of Prussia, PA 19406-1438

Mailing address

PO Box 13869
Philadelphia, PA 19101-3869
Phone (610) 340-3530

Other practice location 1

735 Fitzwatertown Rd Ste 2
Willow Grove, PA 19090-1338
Phone (215) 938-1515

Other identifiers 1

IdentifierTypeStateIssuer
RN225600LOtherPALICENSE

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN225600LPAMDAmbulatory Women's Health Care Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Reproductive Medicine Associates of Philadelphia Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558569600000",
    "number": "1225695331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13869",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191013869",
            "telephone_number": "610-340-3530",
            "fax_number": "610-337-0185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 CLARK AVE STE 17B",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194061438",
            "telephone_number": "215-654-1544",
            "fax_number": "215-654-1543"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "735 Fitzwatertown Rd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Willow Grove",
            "state": "PA",
            "postal_code": "190901338",
            "country_code": "US",
            "telephone_number": "215-938-1515",
            "fax_number": "215-938-8756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "LINDA",
        "middle_name": "KELLY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-23",
        "last_updated": "2019-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "PA",
            "license": "RN225600L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "RN225600L",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in King of Prussia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2019; 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.