Individual provider Active NPI

Chandler Bray Graham, PA

  • Physician Assistant
  • Florence, SC
National Provider Identifier
1285414151
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MPA.5064 Issued in SC
Practice address
401 E Cheves St Ste 301
Florence, SC 29506-2615
Phone
(843) 777-7166
NPI assigned
Sep 29, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MPA.5064 SC Primary

Addresses

Primary practice location

401 E Cheves St Ste 301
Florence, SC 29506-2615

Mailing address

103 Darden Dr
Poquoson, VA 23662-1213
Phone (757) 951-3375

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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

Enrollment IDStateProvider typePAC IDDetails
I20240123001920 SC Practitioner - Physician Assistant 7719339001 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Medical University of South Carolina College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLeod Regional Medical Center of the Pee Dee IncGroup PAC ID 7416851852, 401 clinicians

Practice addresses (Care Compare)

555 E Cheves St
Florence, SC 29506-2617
Phone (843) 777-2000

Hospital & facility affiliations

  • McLeod Regional Medical Center-Pee Dee Hospital, Florence, SC, CCN 420051
  • McLeod Health Cheraw Hospital, Cheraw, SC, CCN 420107
  • Musc Health Florence Medical Center Hospital, Florence, SC, CCN 420091
  • McLeod Medical Center - Dillon Hospital, Dillon, SC, CCN 420005
  • McLeod Loris Hospital Hospital, Loris, SC, CCN 420105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MPA.5064SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Regional Medical Center of the Pee Dee, Inc CurrentSince Sep 15, 2024 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc CurrentSince Sep 15, 2024 Accepting new patients
McLeod Physician Associates II CurrentSince Dec 11, 2023 Accepting new patients

Locations

800 E Cheves St
Ste 480A
Florence, SC 29506
Phone (843) 777-7337

800 E Cheves St
Ste 240
Florence, SC 29506
Phone (843) 777-7950

401 E Cheves St
Ste 301
Florence, SC 29506
Phone (843) 777-7166

506 E Cheves St
#202
Florence, SC 29506

555 E Cheves St
Florence, SC 29506
Phone (843) 662-5233

Interoperability endpoints

  • Direct secure messaging: cgraham87664@directmcleodehealth.org

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1695945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1285414151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 DARDEN DR",
            "city": "POQUOSON",
            "state": "VA",
            "postal_code": "236621213",
            "telephone_number": "757-951-3375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E CHEVES ST STE 301",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062615",
            "telephone_number": "843-777-7166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "CHANDLER",
        "middle_name": "BRAY",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-29",
        "last_updated": "2023-09-29",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "MPA.5064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

Verify at the official NPI Registry.