Jeremy Jayme Graham, RN, MSN, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

22686 Issued in CA

Practice address

1100 S Eliseo Dr Ste 1
Greenbrae, CA 94904

Phone

(415) 514-5000

Fax

(415) 502-5550

NPI assigned

Jun 13, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539043200000",
    "number": "1841552924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 LOCKSLEY AVE APT 7F",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941223849",
            "telephone_number": "609-674-8193",
            "fax_number": "415-502-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S ELISEO DR STE 1",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "94904",
            "telephone_number": "415-514-5000",
            "fax_number": "415-502-5550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 S Eliseo Dr Ste 1",
            "address_purpose": "LOCATION",
            "city": "Greenbrae",
            "state": "CA",
            "postal_code": "949042017",
            "country_code": "US",
            "telephone_number": "415-514-5000",
            "fax_number": "415-502-5550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "JEREMY",
        "middle_name": "JAYME",
        "name_prefix": "Mr.",
        "credential": "RN, MSN, NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-13",
        "last_updated": "2018-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "829229",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR14301200",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN601208",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "22686",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "22686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Gleason, PA-C
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• Chad James Goodman, M.D.
• Flash Gordon, M.D.
• Tofani Grava, LMFT
• Andrea Gray, M.D.
• Greenbrae Care Center, LLC (Kindred Transitional Care and Rehabilitation-South Marin)
• Greenbrae Dermatology, a Medical Corporation
• Greenbrae Surgery Center

• Nurse Practitioner in Greenbrae, CA
• Providers in Greenbrae, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.