Individual provider Active NPI

Courtney A Graham, FNP

  • Family Nurse Practitioner
  • Cooperstown, NY
National Provider Identifier
1659616605
Registry record updated Dec 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
33337689 Issued in NY
Practice address
1 Atwell Rd
Adult Primary Care
Cooperstown, NY 13326-1301
Phone
(607) 547-3456
NPI assigned
Dec 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2012

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 33337689 NY Primary

Addresses

Primary practice location

1 Atwell Rd
Adult Primary Care
Cooperstown, NY 13326-1301

Mailing address

1 Atwell Rd
Cooperstown, NY 13326-1301
Phone (607) 547-3456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20130327000621 NY Practitioner - Nurse Practitioner 5395980114 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33337689NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Imogene Bassett Hospital CurrentSince Jan 7, 2013 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Jan 7, 2013 Accepting new patients
Gilbertsville-Mt. Upton Central School District Past Accepting new patients

Locations

597 County Highway 54
Cherry Valley, NY 13320
Phone (607) 264-3265

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

21 Walnut St
Cooperstown, NY 13326
Phone (607) 547-5069

39 Linden Ave
Cooperstown, NY 13326
Phone (607) 547-1105

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

2 Sheldon Dr
Delhi, NY 13753
Phone (607) 746-2105

693 State Highway 51
Gilbertsville, NY 13776
Phone (607) 783-2207

4238 State Highway 8
New Berlin, NY 13411
Phone (607) 847-6050

Organizations & group practices 3

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": "1354492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354492800000",
    "number": "1659616605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133261301",
            "telephone_number": "607-547-3456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "address_2": "ADULT PRIMARY CARE",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "133261301",
            "telephone_number": "607-547-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "COURTNEY",
        "middle_name": "A",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-03",
        "last_updated": "2012-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "33337689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cooperstown, NY

Sources for this page

Verify at the official NPI Registry.