Kimberly Graham

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

9053 Issued in WI

Practice address

535 Hospital Rd
New Richmond, WI 54017-1449

Phone

(715) 243-3400

NPI assigned

Feb 23, 2019

Last updated

Feb 23, 2019By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Valley Physician Enterprise, Inc

  • Surgery Physician
  • Winchester, VA
  • NPI 1538316203
  NPD (past)

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

{
    "created_epoch": "1550880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550880000000",
    "number": "1457818759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 CROWN POINTE CURV",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540167776",
            "telephone_number": "814-490-7082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 HOSPITAL RD",
            "city": "NEW RICHMOND",
            "state": "WI",
            "postal_code": "540171449",
            "telephone_number": "715-243-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "KIMBERLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-23",
        "last_updated": "2019-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "9053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Margaret Gibbs, PA-C
• Joel David Gibson
• Goetzke Chiropractic Inc. (Arch Chiropracitc Center)
• Jamilla Goins, MS, SAC, LPC-IT
• Leo Raymond Gonsowski III, DC, CSCS
• Brianna Grahovac, MS, LPC-IT
• Great Lakes Oral & Maxillofacial Surgery, P.a.
• Ericka Green
• Chad James Griffith, M.D.
• Pamels Jo Grover, COTA

• Family Nurse Practitioner in New Richmond, WI
• Providers in New Richmond, WI by specialty
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.