Jae Lynn Graham, PA-C, MS

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA01039 Issued in TX

Practice address

1200 Binz St Ste 400
Houston, TX 77004-6942

Phone

(713) 520-6016

Fax

(713) 893-1342

NPI assigned

Jan 29, 2007

Last updated

Oct 11, 2023By 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

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: jae-lynn.graham@229641889120260.direct.elationemr.com

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1417093253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 BINZ ST STE 400",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770046942",
            "telephone_number": "713-520-6016",
            "fax_number": "713-893-1342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 BINZ ST STE 400",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770046942",
            "telephone_number": "713-520-6016",
            "fax_number": "713-893-1342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "JAE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "PA-C, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA01039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David P Graham, M.D., M.S.
• David Yates Graham, M.D.
• Demetrial D Graham, LPC-A
• Gregory Dane Graham, MD
• Jade Graham
• Jillian S. Graham, PA-C
• Katelynn Graham
• Katherine Haule Graham, PH.D.
• Lakrisha Graham
• Lauren Ann Graham, LPC, NCC, LCDC-INTER

• Physician Assistant in Houston, TX
• Providers in Houston, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.