MS. KELLY ANN GRAHAM PA-C, PTA
NPI 1780031625
Physician Assistant - Medical in Orlando, FL

Q: What is Kelly Graham's NPI number?

The NPI number for Kelly Graham is 1780031625. It was assigned to this individual provider in the NPPES registry on May 20, 2016. The provider is also known as Kelly Ann Campbell.

Q: What is Kelly Graham's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Graham was last updated on August 26, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 20, 2016PECOS EnrolledAccepts Medicare Assignment

1222 S ORANGE AVE, ORLANDO, FL 32806(321) 841-6444(407) 650-1307 Get Directions Write a Review

NPPES record last updated: August 26, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 26, 2020, Nov 5, 2019, Aug 21, 2019 and 2 more (5 updates tracked since 2016).

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About Ms. Kelly Ann Graham Pa-c, Pta NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. KELLY ANN GRAHAM PA-C, PTA (NPI 1780031625) is an individual medical provider in Orlando, Florida, licensed in Florida (PA112573) and active in the NPI registry since May 2016. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1780031625

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameMS. KELLY ANN GRAHAMCredential: PA-C, PTA

Location Address1222 S ORANGE AVEOrlando, FL 32806-1215

Mailing Address1222 S Orange AveOrlando, FL 32806-1215 · (321) 841-6444 · Fax (407) 650-1307

Phone(321) 841-6444

Fax(407) 650-1307

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateMay 20, 2016

Last NPPES UpdateAugust 26, 20205 updates tracked since enumeration

NPPES CertifiedAugust 26, 2020

✔ NPI 1780031625 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in FL · PA112573

Also ListedPhysical Therapy AssistantTaxonomy 225200000X · License 26641 (FL)

Also ListedPhysician AssistantTaxonomy 363A00000X · License 9112573 (FL)

1222 S ORANGE AVE, Orlando, FL 32806

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Other Names 1

Former Name (1)Kelly Ann Campbell

Other Identifiers 1

Medicaid104300400FL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ms. Kelly Ann Graham Pa-c, Pta is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2567794837

PECOS Enrollment IDI20220105001820

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRYAN DAVID BROWN MD

Orthopaedic Surgery (Hand Surgery)

1222 S ORANGE AVE, 5TH FLOOR
ORLANDO, FL 32806

Orange County (321) 841-1764

KAREN LEONIA WALKER M.D.

Thoracic Surgery (Cardiothoracic Vascular Surgery)