Individual provider Active NPI

Janet Marie Graham, APRN

  • Family Nurse Practitioner
  • Edwards, CO
National Provider Identifier
1396169389
Registry record updated Feb 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0990802 Issued in CO
Practice address
56 Edwards Village Blvd
Ste 208
Edwards, CO 81632-7802
Phone
(303) 338-4545
NPI assigned
Feb 11, 2014
Last updated
Feb 5, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0990802 CO Primary

Addresses

Primary practice location

56 Edwards Village Blvd
Ste 208
Edwards, CO 81632-7802

Mailing address

56 Edwards Village Blvd
Ste 208
Edwards, CO 81632-7802
Phone (303) 338-4545

Other identifiers 2

IdentifierTypeStateIssuer
027123OtherCOKAISER COMMERCIAL NUMBER
26034361MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20150129002331 CO Practitioner - Nurse Practitioner 9234453846 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0990802COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
True North Health Navigation LLC CurrentSince Oct 5, 2015 Accepting new patients

Locations

5825 Delmonico Dr
Ste 101
Colorado Springs, CO 80919
Phone (706) 315-2523

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1392076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486252800000",
    "number": "1396169389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 EDWARDS VILLAGE BLVD",
            "address_2": "STE 208",
            "city": "EDWARDS",
            "state": "CO",
            "postal_code": "816327802",
            "telephone_number": "303-338-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 EDWARDS VILLAGE BLVD",
            "address_2": "STE 208",
            "city": "EDWARDS",
            "state": "CO",
            "postal_code": "816327802",
            "telephone_number": "303-338-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "JANET",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-11",
        "last_updated": "2017-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "0990802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "027123",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "26034361",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwards, CO

Sources for this page

Verify at the official NPI Registry.