Angela Graham, CFNP
Individual provider Active NPI Family Nurse Practitioner · Sebastopol, MS
NPI 1407884356 · NPPES record last updated Nov 12, 2025
Key facts
- NPI
- 1407884356
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R855944 (MS)
- Practice address
- 17509 Highway 21 South
Sebastopol, MS 39359-0082 - Phone
- (601) 267-1320
- Fax
- (601) 267-5422
- NPI assigned
- Jun 29, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fast Pace Mississippi PLLC
Baptist Medical Center-Leake, Inc.
Medical Foundation of Central Mississippi Inc
Practice addresses (Care Compare)
1017 W Beacon St
Philadelphia, MS 39350-3218
Phone (769) 200-0730
1100 Hwy 16 E
Carthage, MS 39051-4222
Phone (601) 267-1470
115 Hwy 16 W
Carthage, MS 39051-4240
Phone (931) 253-1110
1225 N State St
Jackson, MS 39202-2064
Phone (601) 292-4261
151 E Metro Dr
Flowood, MS 39232-4405
151 E Metro Pkwy
Suite 201
Flowood, MS 39232-4405
Phone (601) 973-1680
242 Thaggard Rd
Madden, MS 39109
Phone (601) 267-1320
50 Veterans Memorial Dr
Kosciusko, MS 39090-3424
Phone (662) 307-2884
517 City Ave S
Ripley, MS 38663-2517
Phone (662) 587-8206
Hospital & facility affiliations
- Accentcare Home Health of Carthage
- Baptist Medical Center-Leake
- Mississippi Baptist Medical Center
- S E Lackey Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070625000419 | MS | Practitioner - Nurse Practitioner | 0648379149 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R855944 | MS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fast Pace Mississippi, PLLC | Family | Current |
Accepting new patients |
| Medical Foundation of Central Mississippi, Inc. | Current |
Accepting new patients | |
| Medical Foundation of Central Ms | Current |
Accepting new patients | |
| Baptist Medical Center-Leake Inc | Current |
Accepting new patients | |
| Upperline Healthcare, PC | Current |
Accepting new patients | |
| Upperline Healthcare, PC | Current |
Accepting new patients | |
| Baptist Medical Center-Leake, Inc | Current | Accepting new patients | |
| Fast Pace Mississippi, PLLC | Current |
Accepting new patients | |
| BMC - Attala, LLC | Current |
Accepting new patients |
Locations (25 of 34)
1490 W Government St
Ste 10
Brandon, MS 39042
Phone (601) 825-1936
1621 W Peace St
Canton, MS 39046
Phone (601) 391-2716
1100 Highway 16 E
Carthage, MS 39051
Phone (601) 267-1100
302 Ellis St
Carthage, MS 39051
Phone (601) 267-1100
115 Highway 16 W
Carthage, MS 39051
Phone (601) 298-3101
310 Ellis St
Carthage, MS 39051
Phone (601) 267-1100
619 S State St
Clarksdale, MS 38614
Phone (662) 812-1229
106 Clinton Pkwy
Clinton, MS 39056
Phone (601) 924-9005
151 E Metro Dr
Ste 103
Flowood, MS 39232
Phone (601) 992-3288
1061 Highway 35 S
Forest, MS 39074
Phone (601) 541-4310
102 Lexington Dr
#100
Gluckstadt, MS 39110
Phone (601) 973-1688
2009 Highway 82 W
Greenwood, MS 38930
Phone (662) 595-4601
700 Sunset Dr
Grenada, MS 38901
Phone (662) 307-2884
7 Professional Pkwy
Ste 101
Hattiesburg, MS 39402
Phone (601) 781-1661
6250 Old Canton Rd
Ste 100
Jackson, MS 39211
Phone (601) 957-1015
1200 N State St
#10
Jackson, MS 39202
Phone (601) 362-7280
1225 N State St
Jackson, MS 39202
Phone (601) 292-4261
1200 N State St
Ste LL10
Jackson, MS 39202
Phone (601) 362-7280
6250 Old Canton Rd
Ste 130
Jackson, MS 39211
Phone (601) 956-7280
1200 N State St
Ste 500
Jackson, MS 39202
Phone (601) 352-2273
7275 S Siwell Rd
Jackson, MS 39272
Phone (601) 373-7722
220 Highway 12 W
Kosciusko, MS 39090
Phone (662) 289-4311
2173 Main St
Madison, MS 39110
Phone (601) 605-3858
401 Baptist Dr
Ste 104
Madison, MS 39110
Phone (601) 605-2383
296 Eastside Dr
Newton, MS 39345
Phone (601) 228-8985
Interoperability endpoints
- aatkinson149128@direct.bmhcc.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R855944 | MS | Yes |
Addresses
Primary practice location
17509 Highway 21 South
Sebastopol, MS 39359-0082
Mailing address
965 Ridge Lake Blvd Ste 315
Memphis, TN 38120-9401
Other practice location 1
1100 Highway 16 E
Carthage, MS 39051-4222
Phone (601) 267-1470
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0123601 | Medicaid | MS |
Other names
- Mrs. Angela Marie Graham
Other providers in Sebastopol, MS
- Ashley Kaye Barber
- Nicholas John Dennery II
- Shanna Donald
- East Central Mississippi Health Care Inc
- Malinda Elizabeth Ellis Gilmer
- Gloria Graham
- Telitha K Grant-Spencer
- Hometown Health and Wellness, PLLC
- Independent Healthcare Management, Inc.
- Aser M Kandil
All providers in Sebastopol, MS · Family Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.