Gina Graham, ATC
Specialist/Technologist, Athletic Trainer in Orange Park, FL. Individual provider (NPI-1).
NPI number1487747853
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1487747853
- Entity type
- Individual (NPI-1)
- Name
- Gina Graham
- Credential
- ATC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 30, 2006
- Last updated
- Jul 8, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | AL947 | FL | Yes |
Practice location
540 Kingsley AveOrange Park, FL 32073-4847
Phone 904-264-2156
Mailing address
611 Racoon CtJacksonville, FL 32259-1912
Phone 904-287-4569
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 20 Athletic Trainer providers in Orange Park · All 2,903 providers in Orange Park
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