Gloria L Graham, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

A01560 Issued in AR

Practice address

2921 Hwy 77 S
Suite 20
Marion, AR 72364-2367

Phone

(870) 739-5311

Fax

(870) 739-5542

NPI assigned

Jul 31, 2006

Last updated

Sep 26, 2011By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Enrolled in AR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Tyler Emergency Physicians

  • Emergency Medicine Physician
  • West Memphis, AR
  • NPI 1669416384
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316995200000",
    "number": "1275549172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2921 HWY 77 S",
            "address_2": "SUITE 20",
            "city": "MARION",
            "state": "AR",
            "postal_code": "723642367",
            "telephone_number": "870-739-5311",
            "fax_number": "870-739-5542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2921 HWY 77 S",
            "address_2": "SUITE 20",
            "city": "MARION",
            "state": "AR",
            "postal_code": "723642367",
            "telephone_number": "870-739-5311",
            "fax_number": "870-739-5542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "GLORIA",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2011-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AR",
            "license": "A01560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159872758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Morgan Gillenwater
• Danielle Glenn
• Goode Communications, Etc.
• Goode Communications, Etc., Inc.
• Wade Gordon, MHPP
• Aleece Graves
• Alissa Kathryn Gray, OT
• Virginia M Gray
• Linda S Green
• Kathryn Griffin

• Nurse Practitioner in Marion, AR
• Providers in Marion, AR by specialty
• Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2011; 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.