Individual provider Active NPI

Ellen Rosemary Graham, NP

  • Pediatric Nurse Practitioner
  • Washington, DC
National Provider Identifier
1851073977
Registry record updated Jun 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
NP11037755 Issued in DC
Practice address
3800 Reservoir Rd NW
Washington, DC 20007-2113
Phone
(202) 444-3700
NPI assigned
Aug 7, 2023
Last updated
Jun 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X NP11037755 DC Primary

Addresses

Primary practice location

3800 Reservoir Rd NW
Washington, DC 20007-2113

Mailing address

3800 Reservoir Rd NW
Washington, DC 20007-2113

Other names 1

  • Ellen Loughlin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20231120001806 DC Practitioner - Nurse Practitioner 3375991052 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP11037755DCMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Medical Group II LLC CurrentSince May 1, 2025 Accepting new patients
Medstar Medical Group II LLC CurrentSince Sep 27, 2023 Accepting new patients
Medstar Medical Group II LLC CurrentSince May 1, 2025 Accepting new patients
MGMC, LLC CurrentSince Sep 27, 2023 Accepting new patients
Medstar Medical Group II LLC Past Accepting new patients

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

3800 Reservoir Rd NW
Washington, DC 20007
Phone (202) 687-2203

Organizations & group practices 5

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": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782518400000",
    "number": "1851073977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 RESERVOIR RD NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200072113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 RESERVOIR RD NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200072113",
            "telephone_number": "202-444-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "ELLEN",
        "middle_name": "ROSEMARY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-07",
        "last_updated": "2026-06-27",
        "certification_date": "2026-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "DC",
            "license": "NP11037755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELLEN",
            "last_name": "LOUGHLIN",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.