Stacey Traylor Graham, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

205856 Issued in SC

Practice address

3419 Main St
Newberry, SC 29108-4145

Phone

(803) 321-2620

Fax

(803) 321-1158

NPI assigned

Nov 27, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1543276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543276800000",
    "number": "1972073575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3419 MAIN ST",
            "city": "NEWBERRY",
            "state": "SC",
            "postal_code": "291084145",
            "telephone_number": "803-321-2620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3419 MAIN ST",
            "city": "NEWBERRY",
            "state": "SC",
            "postal_code": "291084145",
            "telephone_number": "803-321-2620",
            "fax_number": "803-321-1158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "STACEY",
        "middle_name": "TRAYLOR",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-27",
        "last_updated": "2018-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SC",
            "license": "205856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Nicole Getz, PT, DPT
• Robersena Gibbs Praylow
• Emily Nicole Gilliland, OTR/L
• Delores Glenn
• Grace Healthcare LLC
• Gus Michael Gray, CPSS
• John W. Green, M.D.
• Rebekka Lynn Greenwalt
• Theresa Halfacre
• Wayne Joseph Harsha, M.D.

• Registered Nurse in Newberry, SC
• Providers in Newberry, SC by specialty
• Registered Nurse in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.