Victorius Vandella Graham

Primary specialty

Home Health AideTaxonomy code 374U00000X

Practice address

817 W Virginia Rd
Georgetown, SC 29440-2226

Phone

(843) 359-8280

NPI assigned

Jul 21, 2021

Last updated

Jul 21, 2021By 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 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1356914915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1205",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294421205",
            "telephone_number": "843-359-8280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 W VIRGINIA RD",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294402226",
            "telephone_number": "843-359-8280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "VICTORIUS",
        "middle_name": "VANDELLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-21",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89-1774045",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "861774045",
            "state": "SD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "grahamscaregivingserives@gmail.com",
            "affiliation": "N",
            "endpointDescription": "grahamscaregivingserives@gmail.com",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "817 W Virginia Rd",
            "city": "Georgetown",
            "state": "SC",
            "country_code": "US",
            "postal_code": "294402226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Global Rehabilitation Foundation
• Stephen D Goerz, MD
• William Graham Goggans
• Cathy Gonzales, R.PH.
• Mazie Elizabeth Graham, R.N.
• Marica Green, FNP
• Linda G Greene, CACII, NCAC II
• Benjamin Greenwood, MD
• Brian Joseph Griggs, NP
• Guardian Pharmacy of South Carolina One

• Home Health Aide in Georgetown, SC
• Providers in Georgetown, SC by specialty
• Home Health Aide in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; 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.