Alexis Renee Graven

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209016875 Issued in IL

Practice address

2300 N Edward St Ste 2400
Decatur, IL 62526-4163

Phone

(217) 876-2400

NPI assigned

Nov 8, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Interoperability endpoints

• Direct secure messaging: alexis.graven.p48@direct.medcor.nextgenshare.com

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

{
    "created_epoch": "1510099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1346753738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 N EDWARD ST STE 2400",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 N EDWARD ST STE 2400",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264163",
            "telephone_number": "217-876-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVEN",
        "first_name": "ALEXIS",
        "middle_name": "RENEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-08",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209016875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emilye Jessica Grant, PHYSICIAN ASSISTANT
• Shaylon Carlene Grant, FNP-BC
• Maria Granzotti, M.D.
• Ronald James Grason, M.D.
• Jason Grauer, APRN
• Joshua Graves
• Kadeeja Alivia Claudia Graves
• Cara A Gravlin, ACNP
• Ariana Gray, RBT
• Betelhem Gray

• Nurse Practitioner in Decatur, IL
• Providers in Decatur, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.