Rebecca Graham, CRNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

SP018727 Issued in PA

Practice address

3401 Civic Center Blvd
Philadelphia, PA 19104-4319

Phone

(215) 590-1000

NPI assigned

Apr 20, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Childrens Health Care Associates, Inc

  • Pediatrics Physician
  • Philadelphia, PA
  • NPI 1598869059
  Medicare reassignment NPD
• Childen'S Health Care Associates Inc.

  • Pediatric Registered Nurse
  • Philadelphia, PA
  • NPI 1699860643
  NPD

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

{
    "created_epoch": "1524182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1447747811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1569 SILVER LAKE RD",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190478001",
            "telephone_number": "215-260-0751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 Pheasant Run",
            "address_purpose": "LOCATION",
            "city": "Newtown",
            "state": "PA",
            "postal_code": "189403439",
            "country_code": "US",
            "telephone_number": "215-968-6944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "REBECCA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-20",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP018824",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP018727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lorraine Graham
• Mark G. Graham, M.D.
• Michaelle Graham, M.A.
• Miranda Lynne Graham, PHARMD
• Nathaniel Graham, M.D.
• Ryan Paul Graham, DO
• Perri Beth Gralnick, PA-C
• Lynne Marie Gramberg, PT, ATC, OCS
• Stephen Peter Gramiak IV, LPC
• Kristi Marie Gramlich, M.ED.

• Pediatric Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatric Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; 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.