Physician Compare National (NPI:1417921552)

HEALTHCARE PROVIDER: CARLETTE GRAHAM MD, FCCP

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1417921552
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2961306360
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100421000748
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GRAHAM
	Individual professional last name
Provider First Name	CARLETTE
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	STATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
	Individual professional's medical school
Graduation Year	1990
	Individual professional's medical school graduation year
Primary Specialty	PULMONARY DISEASE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	CRITICAL CARE (INTENSIVISTS)
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	INTERNAL MEDICINE
	Second secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	CRITICAL CARE (INTENSIVISTS), INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	PULMONARY MEDICINE ASSOCIATES
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	9931013760
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	6
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	915 EAGLES LANDING PKWY
	Group Practice or individual's line 1 address
City	STOCKBRIDGE
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	302815011
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	110191
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	PIEDMONT HENRY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	110215
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PIEDMONT FAYETTE HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	110165
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	SOUTHERN REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	110161
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	NORTHSIDE HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y