Anitra Simone Graves, M.D.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

049799 Issued in GA

Practice address

15 Reinhardt College Pkwy
Suite 108
Canton, GA 30114-5257

Phone

(678) 493-2527

Fax

(678) 492-5608

NPI assigned

Jul 12, 2006

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA, IN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Pulmonary DiseaseAlso: Critical Care (Intensivists)

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Good Samaritan Hospital Physician Services, IncGroup PAC ID 3971671330, 143 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Samaritan Hospital Hospital, Vincennes, IN, CCN 150042

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Cherokee Lung & Sleep Specialists, P.C.

  • Pulmonary Disease Physician
  • Canton, GA
  • NPI 1659320224
  Medicare reassignment NPD Authorized official
• Good Samaritan Hospital Physician Services, Inc

  • Hospitalist Physician
  • Vincennes, IN
  • NPI 1649432071

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Northside Primary Care Professional Services,LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1922397553
  Medicare reassignment NPD
• Northside Primary Care Professional Services, LLC

  • Urgent Care Clinic/Center
  • Dawsonville, GA
  • NPI 1215369715
  NPD
• Good Samaritan Hospital

  dba Good Samaritan Family Practice 100

  • Rural Health Clinic/Center
  • Vincennes, IN
  • NPI 1760145973
  NPD
• Northwest Indiana Nephrology PC

  • Nephrology Physician
  • Valparaiso, IN
  • NPI 1285991885
  NPD (past)

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

• Good Samaritan Hospital

  dba Center for Therapy and Sports Performance

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Vincennes, IN
  • NPI 1073153474

  Hospital

  Care Compare affiliation
• Good Samaritan Hospital

  • General Acute Care Hospital
  • Vincennes, IN
  • NPI 1225032881
  Care Compare affiliation

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1285669739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 REINHARDT COLLEGE PKWY",
            "address_2": "SUITE 108",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301145257",
            "telephone_number": "678-493-2527",
            "fax_number": "678-493-5608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 REINHARDT COLLEGE PKWY",
            "address_2": "SUITE 108",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301145257",
            "telephone_number": "678-493-2527",
            "fax_number": "678-492-5608"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "85 E US Highway 6",
            "address_purpose": "LOCATION",
            "city": "Valparaiso",
            "state": "IN",
            "postal_code": "463838947",
            "country_code": "US",
            "telephone_number": "219-983-8300",
            "fax_number": "219-465-1749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "ANITRA",
        "middle_name": "SIMONE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-12",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "49799",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "GA",
            "license": "049799",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "IN",
            "license": "01078528A",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "GA",
            "license": "049799",
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "GA",
            "license": "49799",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "289374423A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Venu Gourineni, MD
• Keasha Grace
• Alison Elizabeth Graf
• Susan Michele Gramling, PHARMD
• Emilio Grandez, RPH
• Wendy Renee Greco, OTR/L
• Andrea Jai Green, PHARMD
• Catherine Larsen Green, PA
• Elizabeth D. Green, LCSW
• James Oliver Green Jr.

• Pulmonary Disease Physician in Canton, GA
• Providers in Canton, GA by specialty
• Pulmonary Disease Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.