Individual provider Active NPI

Anna Lorraine Libradilla Graham, FNP

  • Family Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1568188092
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
218664 Issued in AZ
Practice address
8950 E Germann Rd Ste 30
Mesa, AZ 85212-5301
Phone
(480) 735-1451
NPI assigned
Oct 17, 2022
Last updated
May 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2024

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 218664 AZ Primary

Addresses

Primary practice location

8950 E Germann Rd Ste 30
Mesa, AZ 85212-5301

Mailing address

20329 S 187TH PL
Queen Creek, AZ 85142-3598
Phone (480) 735-1451

Other practice location 1

20329 S 187th Pl
Queen Creek, AZ 85142-3598
Phone (480) 735-1451

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20230602001948 AZ Practitioner - Nurse Practitioner 6709243918 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Graham Health LLCGroup PAC ID 0840656336, 2 clinicians

Practice addresses (Care Compare)

20329 S 187TH PL
Queen Creek, AZ 85142-3598
Phone (480) 743-6933

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
West Coast Wound and Skin Care Inc CurrentSince Aug 30, 2023 Accepting new patients
Graham Health LLC Family CurrentSince Apr 16, 2023 Accepting new patients

Locations

3706 Highway 95
Ste 101
Bullhead City, AZ 86442
Phone (928) 201-9286

5240 E Knight Dr
Ste 116
Tucson, AZ 85712
Phone (520) 320-5665

2501 W Burbank Blvd
Ste 200
Burbank, CA 91505
Phone (818) 732-8272

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.

Hospital & facility affiliations 5

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": "1665964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1568188092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20329 S 187TH PL",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851423598",
            "telephone_number": "480-735-1451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8950 E GERMANN RD STE 30",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852125301",
            "telephone_number": "480-735-1451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20329 S 187th Pl",
            "address_purpose": "LOCATION",
            "city": "Queen Creek",
            "state": "AZ",
            "postal_code": "851423598",
            "country_code": "US",
            "telephone_number": "480-735-1451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "ANNA LORRAINE",
        "middle_name": "LIBRADILLA",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-17",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "218664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.