Active NPI
Nicole Graham
- Peer Specialist
- Newark, NJ
National Provider Identifier
1871248948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- Practice address
- 1091 Broad Street
Newark, NJ 07114 - Phone
- (973) 623-0600
- NPI assigned
- Feb 17, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | Primary |
Addresses
Primary practice location
1091 Broad Street
Newark, NJ 07114
Mailing address
103 Lincoln Park
Newark, NJ 07102-2391
Phone (973) 623-0600
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | nicole_graham@integrityhouse.org | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrity, Inc | Past | Accepting new patients | |
| Integrity, Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Adult Mental Health Clinic/Center
- Newark, NJ
- NPI 1164092631
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Newark, NJ
- NPI 1487253779
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1645056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645056000000",
"number": "1871248948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 LINCOLN PARK",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071022391",
"telephone_number": "973-623-0600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1091 BROAD STREET",
"city": "NEWARK",
"state": "NJ",
"postal_code": "07114",
"telephone_number": "973-623-0600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "NICOLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-02-17",
"last_updated": "2022-02-17",
"certification_date": "2022-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "nicole_graham@integrityhouse.org",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "1091 Broad Street",
"city": "Newark",
"state": "NJ",
"country_code": "US",
"postal_code": "07114",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.