Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Kelly Ann Graham, PA-C, PTA

Individual provider Physical Therapy Assistant · NPI 1780031625

MS. Kelly Ann Graham, PA-C, PTA is a Physician Assistant in Orlando, Florida. Qualified in 2019, 7 years ago. Practices with The Southeast Permanente Medical Group, a 826-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
7
Licensed in
FL
In the registry since
2016
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

1222 S Orange Ave
Orlando, FL 32806-1215
Phone: (321) 841-6444
Fax: (407) 650-1307
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA112573 (FL)
Physical Therapy Assistant Taxonomy 225200000X · Licence 26641 (FL)
Physician Assistant Taxonomy 363A00000X · Licence 9112573 (FL)

Record details

NPI number1780031625
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C , PTA
Sole proprietorNo
NPI enumeratedMay 20, 2016
Last updated in NPPESAugust 26, 2020
Certification dateAugust 26, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice The Southeast Permanente Medical Group — 826 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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