Individual provider Active NPI

Bracy B Graham II, CRNA

  • Certified Registered Nurse Anesthetist
  • Newnan, GA
National Provider Identifier
1891860169
Registry record updated Apr 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN169732 Issued in GA
Practice address
1755 Highway 34 E
Suite 1100
Newnan, GA 30265-5631
Phone
(770) 252-7510
Fax
(770) 252-7511
NPI assigned
Nov 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN169732 GA Primary
Certified Registered Nurse Anesthetist 367500000X 50304 TX

Addresses

Primary practice location

1755 Highway 34 E
Suite 1100
Newnan, GA 30265-5631

Mailing address

3025 Sharpsburg McCullum Rd
BLDG B
Newnan, GA 30265-6107
Phone (770) 251-2060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230728002902 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7517934193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Digestive Disease ConsultantsGroup PAC ID 1850515040, 18 clinicians

Practice addresses (Care Compare)

2151 Riverside Ave
Jacksonville, FL 32204-4416
Phone (904) 388-8686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
50304TXMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Digestive Disease Consultants Nurse Anesthetist, Certified Registered CurrentSince Apr 19, 2023 Accepting new patients
Medical Center Medical Group Past Accepting new patients
United Anesthesia Associates LLC Nurse Anesthetist, Certified Registered PastSince Sep 26, 2017 Accepting new patients
Alta Anesthesia Associates of Georgia, PC Nurse Anesthetist, Certified Registered PastSince Nov 11, 2012 Accepting new patients
Clinical Partners PA Nurse Anesthetist, Certified Registered Past Accepting new patients
Clinical Associates, Inc Nurse Anesthetist, Certified Registered Past Accepting new patients
Sweet Dreams of Albany LLC Nurse Anesthetist, Certified Registered PastSince Nov 20, 2016 Accepting new patients
Sweet Dreams Nurse Anesthesia of Georgia LLC Nurse Anesthetist, Certified Registered PastSince Nov 20, 2016 Accepting new patients
Sentry Anesthesia Management, LLC Past Accepting new patients
Southern Crescent Anesthesiology, PC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

2151 Riverside Ave
Jacksonville, FL 32204
Phone (904) 381-8900

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301961600000",
    "number": "1891860169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3025 SHARPSBURG MCCULLUM RD",
            "address_2": "BLDG B",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302656107",
            "telephone_number": "770-251-2060",
            "fax_number": "770-251-8567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 HIGHWAY 34 E",
            "address_2": "SUITE 1100",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302655631",
            "telephone_number": "770-252-7510",
            "fax_number": "770-252-7511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "BRACY",
        "middle_name": "B",
        "name_suffix": "II",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2011-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "GA",
            "license": "RN169732",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TX",
            "license": "50304",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.