NPIMap

Individual provider Active NPI

Gloria Graham, M.D.

  • Family Medicine Physician
  • Sebastopol, MS
National Provider Identifier
1932519964
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
27211 Issued in MS
Practice address
1488 Hwy 487
Sebastopol, MS 39359
Phone
(601) 625-7403
NPI assigned
Apr 29, 2014
Last updated
Jun 16, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 27211 MS Primary

Addresses

Primary practice location

1488 Hwy 487
Sebastopol, MS 39359

Mailing address

1488 Hwy 487
Sebastopol, MS 39359
Phone (601) 625-7403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201102001873 MS Practitioner - Family Practice 0244506764 Reassigns benefits to 2 organizations
I20230608001120 TX Practitioner - Family Practice 0244506764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Central Mississippi Health Care IncGroup PAC ID 0941103717, shared by 4 NPIs, 16 clinicians

Practice addresses (Care Compare)

1488 Hwy 487
Sebastopol, MS 39359-0150
Phone (601) 625-7403

PO Box
Sebastopol, MS 39359

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
27211MSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mississippi Band of Choctaw Indians CurrentSince Mar 21, 2023 Accepting new patients
Mississippi Band of Choctaw Indians Current Accepting new patients
East Central Mississippi Health Care, Inc. CurrentSince Oct 30, 2023 Accepting new patients
East Central Mississippi Health Care, Inc Current Accepting new patients
Mississippi Band of Choctaw Indians Current Accepting new patients
Mississippi Band of Choctaw Indians CurrentSince Mar 21, 2023 Accepting new patients
Medical Foundation, Inc. Family Medicine CurrentSince Dec 1, 2020 Accepting new patients
Medical Foundation, Inc. CurrentSince Dec 1, 2020 Accepting new patients
Mississippi Band of Choctaw Indians Current Accepting new patients
Clinicas de Salud del Pueblo, Inc. Past Accepting new patients
East Central Mississippi Health Care Inc Past Accepting new patients

Locations

1930 N Pearl St
Carthage, MS 39051
Phone (601) 287-6639

210 Hospital Cir
Choctaw, MS 39350
Phone (601) 389-4500

376 Campus Rd
Conehatta, MS 39057
Phone (601) 389-4500

2401 16th St
Meridian, MS 39301
Phone (601) 482-4181

10330 Road 375
Philadelphia, MS 39350
Phone (601) 656-0226

124 Big Creek Cir
Philadelphia, MS 39350
Phone (601) 389-4500

24345 Highway 15
Union, MS 39365
Phone (601) 774-8211

Interoperability endpoints

  • Direct secure messaging: gloria.graham.1@17349.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/17349/brand/1/csg/1/fhir/r4

Organizations & group practices 11

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.

Hospital & facility affiliations 5

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": "1398729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1932519964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1488 HWY 487",
            "city": "SEBASTOPOL",
            "state": "MS",
            "postal_code": "39359",
            "telephone_number": "601-625-7403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1488 HWY 487",
            "city": "SEBASTOPOL",
            "state": "MS",
            "postal_code": "39359",
            "telephone_number": "601-625-7403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "GLORIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-29",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "27211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastopol, MS

Sources for this page

Verify at the official NPI Registry.