Active NPI
Cassidy Lynn Graham, AGACNP
- Acute Care Nurse Practitioner
- Chesterfield, MO
National Provider Identifier
1619550423
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 2021005553
- Practice address
- 1036 Town and Country Crossing Dr
Chesterfield, MO 63017-0610 - Phone
- (314) 833-9000
- NPI assigned
- Apr 29, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 2021005553 | MO | Primary |
Addresses
Primary practice location
1036 Town and Country Crossing Dr
Chesterfield, MO 63017-0610
Mailing address
1251 Strassner Dr Unit 2313
Saint Louis, MO 63144-1881
Phone (309) 319-3368
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021005553 | MO | MD | Acute Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704758400000",
"number": "1619550423",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1251 STRASSNER DR UNIT 2313",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631441881",
"telephone_number": "309-319-3368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1036 TOWN AND COUNTRY CROSSING DR",
"city": "CHESTERFIELD",
"state": "MO",
"postal_code": "630170610",
"telephone_number": "314-833-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "CASSIDY",
"middle_name": "LYNN",
"credential": "AGACNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-29",
"last_updated": "2024-01-09",
"certification_date": "2024-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "MO",
"license": "2021005553",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chesterfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.