MS. KELLY ANN GRAHAM (NPI# 1780031625) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1780031625 |
Entity Type | Individual |
Full Name | MS. KELLY ANN GRAHAM |
Other Name | KELLY ANN CAMPBELL |
Credential | PA-C, PTA |
Practice Address |
1222 S Orange Ave Orlando FL 32806-1215 |
Practice Telephone | 3218416444 |
Practice Fax Number | 4076501307 |
Mailing Telephone | 3218416444 |
Mailing Fax Number | 4076501307 |
Enumeration Date | 2016-05-20 |
Last Update Date | 2020-08-26 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 225200000X | Physical Therapy Assistant | 26641 | FL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
N | 363A00000X | Physician Assistant | 9112573 | FL | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA112573 | FL | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FL | 104300400 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134669682 | Kelly Graham | Specialist/Technologist | 601 Custis Rd, Glenside, PA 19038-2013 | 2017-03-02 |
1649446774 | Kelly Ann Graham | Occupational Therapist | 161 Se 5th Ct, Pompano Beach, FL 33060-7164 | 2008-05-08 |
1447239629 | Kelly Leigh Graham | Optometrist | 113 N Plaza Ct, Van Buren, AR 72956-2269 | 2006-01-16 |
1396258232 | Kelly Marie Graham | Counselor | 2005 Ashland Ave, Toledo, OH 43620-1703 | 2017-11-14 |
1720530629 | Kelly Graham | Nurse Practitioner | 2075 Glenn Mitchell Dr, Suite 500, Virginia Beach, VA 23456-0179 | 2016-10-26 |
1174915862 | Kelly Graham | Counselor | 5648 Friendship Ave, Pittsburgh, PA 15206-3610 | 2015-03-04 |
1750783981 | Kelly Graham | Speech-Language Pathologist | 1349 Empire Central Dr, Suite 516, Dallas, TX 75247-4066 | 2014-09-18 |
1417369240 | Kelly Graham | Massage Therapist | 10021 Holman Rd Nw, Seattle, WA 98177-4920 | 2014-05-28 |
1821410309 | Kelly Jean Graham | Behavioral Analyst | 780 Lynnhaven Pkwy Ste 400, Virginia Beach, VA 23452-7332 | 2014-01-17 |
1588093157 | Kelly Graham | Physician Assistant | 960 Johnson Ferry Rd, Ste 100, Atlanta, GA 30342-1631 | 2013-11-05 |
Street Address |
1222 S ORANGE AVE |
City | ORLANDO |
State | FL |
Zip Code | 32806-1215 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376546986 | Steven J Hoff | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1222 S Orange Ave, Orlando, FL 32806-1215 | 2005-05-27 |
1639793623 | Mikayla Alexis Ruane | Physician Assistant | 1222 S Orange Ave, Orlando, FL 32806-1215 | 2020-06-04 |
1699308536 | Bethany Kelley | Nurse Practitioner | 1222 S Orange Ave, Orlando, FL 32806-1215 | 2020-02-19 |
1194364620 | Cody Albert Pigon | Nurse Practitioner | 1222 S Orange Ave, Orlando, FL 32806-1215 | 2020-01-01 |
1528600442 | Jennie K Ayers | Physician Assistant | 1222 S Orange Ave, Orlando, FL 32806-1215 | 2019-10-11 |
1376193458 | David Estalilla | Physician Assistant | 1222 S Orange Ave, Orlando, FL 32806-1215 | 2019-09-19 |
1437709664 | Brannen Allen Davis | Physician Assistant | 1222 S Orange Ave, Orlando, FL 32806-1215 | 2019-09-19 |
1386294098 | Heidi Lyn Seymour | Physician Assistant | 1222 S Orange Ave, Orlando, FL 32806-1215 | 2019-09-14 |
1437703592 | Paige Salerno | Physician Assistant | 1222 S Orange Ave, Orlando, FL 32806-1215 | 2019-07-27 |
1174175285 | Amanda Kay Graham | Registered Nurse | 1222 S Orange Ave, Orlando, FL 32806-1215 | 2019-07-10 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1710585674 | Erika Williams | Pharmacist | 2715 South Orlando Ave, Orlando, FL 32806 | 2020-10-13 |
1013545664 | Johanna Yadira Cook | Registered Nurse | Orlando Health Orlando Regional Medical Center, 52 W. Underwood St, Orlando, FL 32806 | 2020-03-30 |
1396372306 | Warren Andrew Williams | Student in an Organized Health Care Education/Training Program | 1222 S. Orange Ave., 5th Fl, Mp# 43, Orlando, FL 32806 | 2020-03-27 |
1225665433 | Astrid Helen Casin | Student in an Organized Health Care Education/Training Program | 1222 S. Orange Avenue, 5th Fl., Mp#43, Orland, FL 32806 | 2020-03-26 |
1508404211 | Hidden Potential Florida LLC | Assistant Behavior Analyst | 2857 South Bumby Avenue, Orlando, FL 32806 | 2019-12-12 |
1720639883 | Cynthia Lee Kling | Clinical Nurse Specialist | Arnold Palmer Hospital, 92 W. Miller St., Orlando, FL 32806 | 2019-09-20 |
1033769930 | Darleen Ann Williams | Clinical Nurse Specialist | 52 W. Underwood, Orlando, FL 32806 | 2019-09-13 |
1508412644 | Trischaday Kimberley Demetrius | Nurse Practitioner | Orlando Epilepsy Center, 226 W Michigan Street, Orlando, FL 32806 | 2019-08-14 |
1962964809 | Ajc Software Inc | Prosthetic/Orthotic Supplier | 1405 South Orange Avenue Suite 308, Orlando, FL 32806 | 2019-04-01 |
1598232852 | Sodo Smiles Dentistry, Pa | Dentist | 3123 S. Orange Ave., Suite 107, Orlando, FL 32806 | 2018-10-25 |
Find all providers in zip 32806 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770054843 | Cynthia Marie Mills | Physician Assistant | 7806 Lake Underhill Rd Ste 104, Orlando, FL 32822-8232 | 2018-12-16 |
1447751029 | Brittney Marie Osterhoudt | Physician Assistant | 2014 S Orange Ave Ste 101, Orlando, FL 32806-3069 | 2018-02-28 |
1164934006 | Stephanie Carmen Oberweger | Physician Assistant | 8124 Chianti Dr, Orlando, FL 32836-5311 | 2017-11-01 |
1881046407 | Chrystal Danielle Fravel | Physician Assistant | 2609 S Orange Ave, Orlando, FL 32806-4547 | 2016-07-07 |
1922498740 | Taylor Stetson | Physician Assistant | 7403 Sugar Bend Dr, Orlando, FL 32819-7215 | 2015-02-01 |
1619370103 | Emily R Avgeropoulos | Physician Assistant | 7512 Dr Phillips Blvd Ste 50-209, Orlando, FL 32819-5420 | 2014-09-29 |
1417357567 | Allyson Lee | Physician Assistant | 3090 Caruso Ct, Orlando, FL 32806-8510 | 2014-08-26 |
1386052371 | Nancy Callaham | Physician Assistant | 6953 Cadiz Blvd, Orlando, FL 32819-4713 | 2014-07-23 |
1922367010 | Quality Care Providers | Physician Assistant | 5565 Cinderlane Pkwy, 291, Orlando, FL 32808-4705 | 2012-05-09 |
1013212067 | Rheumatology Associates of Central Fl. | Physician Assistant | 3160 Southgate Commerce Blvd Bldg Suite30, Orlando, FL 32806-8549 | 2011-01-24 |
Find all providers in ORLANDO |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.