Sutton L Graham II, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

11893 Issued in SC

Practice address

615 Halton Rd
Suite 100
Greenville, SC 29607

Phone

(864) 676-1707

Fax

(864) 676-9256

NPI assigned

Sep 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972601888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 HALTON RD",
            "address_2": "SUITE 100",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "29607",
            "telephone_number": "864-676-1707",
            "fax_number": "864-676-9256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 HALTON RD",
            "address_2": "SUITE 100",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "29607",
            "telephone_number": "864-676-1707",
            "fax_number": "864-676-9256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "SUTTON",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "SC",
            "license": "11893",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP0192",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda B Graham, LISW
• Matthew Timothy Graham, M.D.
• Raetonya Davette Graham, LISW-CP
• Shannon M. Graham, LMSW
• Shelbye Lynn Graham, MSOT, OTR
• Taylor Graham
• Zarina Graham, MA, NCC, LPC
• Joseph P Grajo, DO
• Emma Delainey Granado
• Brianna Grande, RD, LDN, CPT

• Plastic Surgery Physician in Greenville, SC
• Providers in Greenville, SC by specialty
• Plastic Surgery Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.