Individual provider Active NPI

Neil Monroe Graham

  • Certified Registered Nurse Anesthetist
  • Huntsville, AL
National Provider Identifier
1467924027
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-145285 Issued in AL
Practice address
101 Sivley Rd SW
Huntsville, AL 35801-4421
Phone
(256) 265-8120
NPI assigned
Dec 20, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 901701 MS
Certified Registered Nurse Anesthetist 367500000X 1-145285 AL Primary

Addresses

Primary practice location

101 Sivley Rd SW
Huntsville, AL 35801-4421

Mailing address

101 Sivley Rd SW
Huntsville, AL 35801-4470

Other practice location 1

415 S 28th Ave
Hattiesburg, MS 39401-7246
Phone (601) 261-3606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190416002650 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 1153662317 Reassigns benefits to 1 organization
I20210518000098 MS Practitioner - Certified Registered Nurse Anesthetist (Crna) 1153662317 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hattiesburg Clinic PAGroup PAC ID 5193706794, 525 clinicians
Lifelinc Anesthesia PLLCGroup PAC ID 0941347447, 169 clinicians

Practice addresses (Care Compare)

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 264-6000

5001 Hardy St
Hattiesburg, MS 39402-1308
Phone (601) 268-8000

Hospital & facility affiliations

  • Merit Health Wesley Hospital, Hattiesburg, MS, CCN 250094
  • Forrest General Hospital Hospital, Hattiesburg, MS, CCN 250078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
1-145285ALMDCertified Registered Nurse Anesthetist
901701MSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Hattiesburg Clinic PA CurrentSince Nov 25, 2024 Accepting new patients
Huntsville Hospital Anesthesia Nurse Anesthetist, Certified Registered CurrentSince Feb 2, 2019 Accepting new patients
Lifelinc Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2021 Accepting new patients
Hattiesburg Clinic, PA CurrentSince Nov 25, 2024 Accepting new patients

Locations

101 Sivley Rd SW
Huntsville, AL 35801
Phone (256) 265-9870

245 Governors Dr SE
Huntsville, AL 35801
Phone (256) 265-7673

634 Leigh Dr
Columbus, MS 39705
Phone (601) 978-3393

5001 Hardy St
Hattiesburg, MS 39402
Phone (601) 268-8000

415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606

1710 W 12th St
Laurel, MS 39440
Phone (601) 369-2021

499 Azalea Dr
Oxford, MS 38655
Phone (662) 234-7979

3340 Players Club Pkwy
Ste 350
Memphis, TN 38125
Phone (901) 207-2017

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1545264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1467924027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 SIVLEY RD SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SIVLEY RD SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014421",
            "telephone_number": "256-265-8120"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "415 S 28th Ave",
            "address_purpose": "LOCATION",
            "city": "Hattiesburg",
            "state": "MS",
            "postal_code": "394017246",
            "country_code": "US",
            "telephone_number": "601-261-3606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "NEIL",
        "middle_name": "MONROE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-20",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MS",
            "license": "901701",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-145285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.