Individual provider Active NPI

Charlotte Johnson Graham, DO

  • Student in an Organized Health Care Education/Training Program
  • Hendersonville, NC
National Provider Identifier
1659710200
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
2579 Chimney Rock Rd
Hendersonville, NC 28792-9181
Phone
(505) 301-7802
NPI assigned
Jun 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

2579 Chimney Rock Rd
Hendersonville, NC 28792-9181

Mailing address

2785 Garnet Dr
North Pole, AK 99705-7321
Phone (505) 301-7802

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240910003884 NC Order and Referring Only - Family PracticePractitioner - Family Practice 3173063799

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Interoperability endpoints

  • Direct secure messaging: charlotte.graham.1@21884.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1659710200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2785 GARNET DR",
            "city": "NORTH POLE",
            "state": "AK",
            "postal_code": "997057321",
            "telephone_number": "505-301-7802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2579 CHIMNEY ROCK RD",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287929181",
            "telephone_number": "505-301-7802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "CHARLOTTE",
        "middle_name": "JOHNSON",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-17",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hendersonville, NC

Sources for this page

Verify at the official NPI Registry.