Active NPI
Virginia Graham, NP
- Women's Health Nurse Practitioner
- New York, NY
National Provider Identifier
1972654200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- F420180-1
- Practice address
- 1111 Amsterdam Ave
Scrymser 3Rd Floor
New York, NY 10025-1716 - Phone
- (212) 523-6500
- Fax
- (212) 523-5677
- NPI assigned
- Jan 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 242410-1 | NY | |
| Women's Health Nurse Practitioner | 363LW0102X | F420180-1 | NY | Primary |
Addresses
Primary practice location
1111 Amsterdam Ave
Scrymser 3Rd Floor
New York, NY 10025-1716
Mailing address
1111 Amsterdam Ave
Scrymser 3Rd Floor
New York, NY 10025-1716
Phone (212) 523-6500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03117911 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 242410-1 | NY | MD | Registered Nurse |
| F420180-1 | NY | MD | Women's Health Nurse Practitioner |
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436140800000",
"number": "1972654200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 AMSTERDAM AVE",
"address_2": "SCRYMSER 3RD FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100251716",
"telephone_number": "212-523-6500",
"fax_number": "212-523-5677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 AMSTERDAM AVE",
"address_2": "SCRYMSER 3RD FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100251716",
"telephone_number": "212-523-6500",
"fax_number": "212-523-5677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "VIRGINIA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-15",
"last_updated": "2015-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "242410-1",
"primary": false
},
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "NY",
"license": "F420180-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03117911",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.