NPIMap

Individual provider Active NPI

Stacy Harold Graham, M.D.

  • Interventional Cardiology Physician
  • Columbia, SC
National Provider Identifier
1912093501
Registry record updated Oct 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
32537 Issued in SC
Practice address
8 Richland Medical Park Dr
Suite 300
Columbia, SC 29203-8005
Phone
(803) 256-6511
Fax
(803) 744-4731
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 32537 SC
Cardiovascular Disease Physician 207RC0000X 32537 SC
Interventional Cardiology Physician 207RI0011X 32537 SC Primary

Addresses

Primary practice location

8 Richland Medical Park Dr
Suite 300
Columbia, SC 29203-8005

Mailing address

PO Box 743904
Atlanta, GA 30374-3904
Phone (803) 296-7320

Other practice location 1

1645 J A Cochran Byp Ste D&h
Chester, SC 29706-2105
Phone (803) 256-6511

Other identifiers 1

IdentifierTypeStateIssuer
325375MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100812000077 SC Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 4385744226 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
University of South Carolina School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians

Practice addresses (Care Compare)

8 Richland Medical Park Dr
Suite 300
Columbia, SC 29203-8008
Phone (803) 256-6511

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands Cardiovascular Disease CurrentSince Sep 25, 2019 Accepting new patients
Prisma Health Medical Group-Midlands Internal Medicine Current Accepting new patients
Prisma Health-Midlands CurrentSince Jan 15, 2012 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Sep 25, 2019 Accepting new patients
Prisma Health-Midlands CurrentSince Jan 15, 2012 Accepting new patients
Prisma Health-Midlands Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1645 J a Cochran Byp
Ste Dh
Chester, SC 29706

8 Richland Medical Park Dr
Ste 300
Columbia, SC 29203
Phone (803) 254-5038

8 Richland Medical Park Dr
Ste 200
Columbia, SC 29203

8 Richland Medical Park Dr
Columbia, SC 29203
Phone (803) 254-5038

300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615

Interoperability endpoints

  • Direct secure messaging: sgraham56954@direct.ghs.myhfn.org

Organizations & group practices 7

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 12

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1912093501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "803-296-7320",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 RICHLAND MEDICAL PARK DR",
            "address_2": "SUITE 300",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292038005",
            "telephone_number": "803-256-6511",
            "fax_number": "803-744-4731"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1645 J A Cochran Byp Ste D&h",
            "address_purpose": "LOCATION",
            "city": "Chester",
            "state": "SC",
            "postal_code": "297062105",
            "country_code": "US",
            "telephone_number": "803-256-6511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "STACY",
        "middle_name": "HAROLD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "32537",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "SC",
            "license": "32537",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "SC",
            "license": "32537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "325375",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.