Individual provider Active NPI

Alison Nicole Graham, D.O.

  • Neonatal-Perinatal Medicine Physician
  • San Diego, CA
National Provider Identifier
1346311107
Registry record updated Dec 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
20A7418 Issued in CA
Practice address
3003 Health Center Dr
San Diego, CA 92123-2700
Phone
(858) 939-4198
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 20A7418 CA
Neonatal-Perinatal Medicine Physician 2080N0001X 20A7418 CA Primary

Addresses

Primary practice location

3003 Health Center Dr
San Diego, CA 92123-2700

Mailing address

8555 Aero Drive, Suite 104
San Diego, CA 92123
Phone (858) 384-7828

Other identifiers 1

IdentifierTypeStateIssuer
00AX74180MedicaidCA

Other names 1

  • Alison Nicole Graham-Gillispie Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20131114000173 CA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 4082840442

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A7418CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rady Children'S Hospital San Diego Past Accepting new patients
Bozeman Health Deaconess Hospital Pediatrics Past Accepting new patients
San Diego Pediatric Neurology, Inc. PastSince Jan 3, 2021 Accepting new patients
Bozeman Health Deaconess Hospital Past Accepting new patients
San Diego Neonatology, Inc. Neonatal-Perinatal Medicine Past Accepting new patients

Organizations & group practices 5

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386720000000",
    "number": "1346311107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8555 AERO DRIVE, SUITE 104",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92123",
            "telephone_number": "858-384-7828",
            "fax_number": "858-598-6344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 HEALTH CENTER DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921232700",
            "telephone_number": "858-939-4198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "ALISON",
        "middle_name": "NICOLE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2013-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A7418",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "CA",
            "license": "20A7418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX74180",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALISON",
            "last_name": "GRAHAM-GILLISPIE",
            "middle_name": "NICOLE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.