Kaitlyn Graham, PA

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

2568 Issued in WV

Practice address

210 2ND St
Saint Marys, WV 26170-1097

Phone

(304) 699-1419

NPI assigned

Nov 8, 2021

Sex

Female

Sole proprietor

Yes

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

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

New Hope Telehealth CorporationGroup PAC ID 9133509730, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• New Hope Telehealth Corporation

  • Psychiatry Physician
  • Williamstown, WV
  • NPI 1730854407
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1636329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1972268530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "597 SOUTHERN HWY",
            "city": "MINERAL WELLS",
            "state": "WV",
            "postal_code": "261501301",
            "telephone_number": "304-210-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 2ND ST",
            "city": "SAINT MARYS",
            "state": "WV",
            "postal_code": "261701097",
            "telephone_number": "304-699-1419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "KAITLYN",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-08",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WV",
            "license": "2568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandra Lane Gatrell
• Debra Gaudioso
• C Richard Gerber, D.D.S.
• Amy Beth Glover
• Karmyn Gouch, LMSW
• Robert Edward Gray
• Paige Gribble, PA-C
• Mary Shawn Edra Haddox
• Gayla Stormie Harvey
• Emily Madaline Herndon

• Psychiatry Physician in Saint Marys, WV
• Providers in Saint Marys, WV by specialty
• Psychiatry Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.