Nicole Graham, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0010-07063 Issued in NC

Practice address

1401 W Innes St
Salisbury, NC 28144-2574

Phone

(704) 636-5626

Fax

(704) 636-5641

NPI assigned

Feb 10, 2017

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

Medicare fee-for-service enrollment

Enrolled in NC

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

Physician Assistant

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Group practices

Piedmont Family Medicine PAGroup PAC ID 8426125816, 4 clinicians

Comprehab, IncGroup PAC ID 2769653757, 376 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Novant Health Rowan Medical Center Hospital, Salisbury, NC, CCN 340015

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Piedmont Family Medicine, P.a.

  • Primary Care Clinic/Center
  • Salisbury, NC
  • NPI 1104968627

  NC

  Medicare reassignment Care Compare group
• Comprehab LLC

  • Physical Therapist
  • Gastonia, NC
  • NPI 1407932775
  Care Compare group

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

• Novant Health Rowan Medical Center LLC

  • General Acute Care Hospital
  • Salisbury, NC
  • NPI 1508843566

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1486684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486684800000",
    "number": "1245778182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 W INNES ST",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442574",
            "telephone_number": "704-636-5626",
            "fax_number": "704-636-5641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 W INNES ST",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442574",
            "telephone_number": "704-636-5626",
            "fax_number": "704-636-5641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-10",
        "last_updated": "2017-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-07063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Wellness and Supportive Services LLC
• Charles Pattison Graham Jr., M.D.
• Kenneth James Graham, PHARMD
• Kim Corbin Graham, COTA
• Lauren Elizabeth Graham, PA-C
• Trevor William Graham, PA-C
• Luann Grambow, L.P.C.
• Rachael Cathrynn Gravel, PA
• Erika Gray, LCSW
• Natalie Kathlean Gray, CADC-R

• All providers in Salisbury, NC
• Medical Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2017; 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.