Individual provider Active NPI

Pearly Berlette Graham-Hoskins, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Elizabethtown, NC
National Provider Identifier
1396834529
Registry record updated May 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
22998 Issued in NC
Practice address
300A East McKay Street
Elizabethtown, NC 28337
Phone
(910) 862-5500
Fax
(910) 862-2107
NPI assigned
Oct 12, 2006
Last updated
May 15, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 22998 NC Primary

Addresses

Primary practice location

300A East McKay Street
Elizabethtown, NC 28337

Mailing address

PO Box 517
300 A East McKay Street
Elizabethtown, NC 28337-0517
Phone (910) 862-5500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20080719000093 NC Practitioner - Internal Medicine 0941211551 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22998NCMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bladen Healthcare LLC Current Accepting new patients
Bladen Healthcare, LLC CurrentSince Jun 1, 2008 Accepting new patients
Bladen Healthcare LLC CurrentSince Jun 1, 2008 Accepting new patients
Bladen Medical Associates Internal Medicine Past Accepting new patients

Locations

300A E McKay St
Elizabethtown, NC 28337
Phone (910) 862-5500

501 S Poplar St
Elizabethtown, NC 28337
Phone (910) 862-4043

1638 Owen Dr
Fayetteville, NC 28304
Phone (910) 609-5610

Interoperability endpoints

  • Direct secure messaging: pgrahamhoskins32417@capefearvalley.direct-ci.com

Organizations & group practices 4

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337040000000",
    "number": "1396834529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 517",
            "address_2": "300 A EAST MCKAY STREET",
            "city": "ELIZABETHTOWN",
            "state": "NC",
            "postal_code": "283370517",
            "telephone_number": "910-862-5500",
            "fax_number": "910-862-2107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300A EAST MCKAY STREET",
            "city": "ELIZABETHTOWN",
            "state": "NC",
            "postal_code": "28337",
            "telephone_number": "910-862-5500",
            "fax_number": "910-862-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM-HOSKINS",
        "first_name": "PEARLY",
        "middle_name": "BERLETTE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2012-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NC",
            "license": "22998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, NC

Sources for this page

Verify at the official NPI Registry.