Individual provider Active NPI

Dylan Graham, MSN, FNP-C

  • Family Nurse Practitioner
  • Cincinnati, OH
National Provider Identifier
1508632449
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F10230160 Issued in OH
Practice address
3636 Springdale Rd
Cincinnati, OH 45251-1407
Phone
(513) 639-9900
NPI assigned
Dec 1, 2023
Last updated
Dec 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F10230160 OH Primary

Addresses

Primary practice location

3636 Springdale Rd
Cincinnati, OH 45251-1407

Mailing address

2620 Elm Hill Pike
Nashville, TN 37214-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20240117003755 OH Practitioner - Nurse Practitioner 5294184248 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
F10230160OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Little Clinic of Ohio LLC Family CurrentSince Jan 8, 2024 Accepting new patients
West Side Pediatrics Past Accepting new patients

Locations

3636 Springdale Rd
Cincinnati, OH 45251
Phone (513) 639-9920

199 Graceland Blvd
Columbus, OH 43214
Phone (614) 410-2814

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/2080/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1701388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1508632449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 ELM HILL PIKE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372143100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 SPRINGDALE RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452511407",
            "telephone_number": "513-639-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "DYLAN",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-01",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "F10230160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.