Carolina Facial Plastic Surgery PA

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

16126 Issued in SC

Legal business name

CAROLINA FACIAL PLASTIC SURGERY PA

Practice address

1714 Gregg Ave
Florence, SC 29501-4120

Phone

(843) 665-0400

Fax

(843) 667-8487

NPI assigned

Jul 21, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Carla Camille Graham, MDNPI 1871541789

Title

Practice Owner

Phone

(843) 665-0400

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carla Camille Graham, M.D.

  • Specialist
  • Florence, SC
  • NPI 1871541789
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579564800000",
    "number": "1679594261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1714 GREGG AVE",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295014120",
            "telephone_number": "843-665-0400",
            "fax_number": "843-667-8487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1714 GREGG AVE",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295014120",
            "telephone_number": "843-665-0400",
            "fax_number": "843-667-8487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA FACIAL PLASTIC SURGERY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "CARLA",
        "authorized_official_middle_name": "CAMILLE",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "843-665-0400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "SC",
            "license": "16126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2827",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Lynn Carnell, MS, OTR/L
• Carolina Blooms Early Intervention
• Carolina Connections & Interventions LLC
• Carolina Counseling Connection, LLC
• Carolina Early Intervention, LLC
• Carolina Family Care Inc
• Carolina Family Care Inc
• Carolina Family Care, Inc
• Carolina Health Care
• Carolina Health Care Retail Pharmacy

• Facial Plastic Surgery Physician in Florence, SC
• Providers in Florence, SC by specialty
• Facial Plastic Surgery Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.