Individual provider Active NPI

Holly F Graham, NP

  • Family Nurse Practitioner
  • Warner Robins, GA
National Provider Identifier
1760109284
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN276201 Issued in GA
Practice address
130 Byrd Way
Warner Robins, GA 31088-8937
Phone
(478) 922-9136
Fax
(478) 923-6846
NPI assigned
Oct 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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 RN276201 GA Primary

Addresses

Primary practice location

130 Byrd Way
Warner Robins, GA 31088-8937

Mailing address

130 Byrd Way
Warner Robins, GA 31088-8937
Phone (478) 922-9136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20231031002345 GA Practitioner - Nurse Practitioner 7315393121 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
Group practices
Women'S Healthcare of Middle Ga, IncGroup PAC ID 8628063203, 20 clinicians

Practice addresses (Care Compare)

130 Byrd Way
Warner Robins, GA 31088-8937
Phone (478) 922-9136

1601 Watson Blvd
Warner Robins, GA 31093-3431
Phone (478) 922-4281

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Women'S Healthcare of Middle Ga, Inc CurrentSince Sep 18, 2023 Accepting new patients
Houston County Emergency Group, LLC CurrentSince Nov 1, 2024 Accepting new patients
Houston County Emergency Group, LLC Current Accepting new patients
Guardian Medical Services, LLC PastSince Oct 30, 2022 Accepting new patients

Locations

1120 Morningside Dr
Perry, GA 31069
Phone (478) 218-1706

1023 Keith Dr
Perry, GA 31069
Phone (478) 922-9136

1601 Watson Blvd
Warner Robins, GA 31093
Phone (478) 322-5155

130 Byrd Way
Warner Robins, GA 31088
Phone (478) 922-9136

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1666656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1760109284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 BYRD WAY",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310888937",
            "telephone_number": "478-922-9136",
            "fax_number": "478-923-6846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 BYRD WAY",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310888937",
            "telephone_number": "478-922-9136",
            "fax_number": "478-923-6846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "HOLLY",
        "middle_name": "F",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-25",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN276201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

Verify at the official NPI Registry.