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

Shannon Graham

Individual provider Family Nurse Practitioner · NPI 1376328583

Shannon Graham is a Nurse Practitioner in Dayton, Ohio. Qualified in 2023, 3 years ago. Practices with Providence Medical Group, a 29-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
3
Licensed in
OH
In the registry since
2023
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

8701 Troy Pike Ste 20
Dayton, OH 45424-1073
Phone: (937) 237-9254
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence APRN.CNP.0033802 (OH)

Record details

NPI number1376328583
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 28, 2023
Last updated in NPPESFebruary 13, 2026
Certification dateFebruary 13, 2026
Mailing address8701 Troy Pike Ste 20, Dayton, OH 45424-1073

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Providence Medical Group — 29 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Dayton