KC GRAHAM (PA-C) – Physician Assistant, NPI 1467857532

KC GRAHAM (PA-C) is a healthcare provider. based in Shelton, Washington. specializing in Physician Assistant. They hold the professional credentials PA-C. They hold a License No. PA60509798 (WA). The NPI Number for KC GRAHAM (PA-C) is 1467857532

Main info

Male
12 Years Of Experience
Accepts Medicare Assignment
Name
KC GRAHAM (PA-C)
NPI
1467857532
Phone
(360) 426-2500
Address
237 PROFESSIONAL WAY
Enumeration Date
30 October 2014
Last Update Date
30 October 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3604262500
Graduation Year
2014 (12 years ago)
PAC ID
2163644105
Group Practice PAC ID
0345139275
Professional Enrollment ID
I20141107000241
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:11State licenses:1Digital endpointsOther names

Provider Addresses for KC GRAHAM (PA-C)

  • 237 PROFESSIONAL WAY

    SHELTON, WA 985844404

    Phone: (360) 426-2500

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-11-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20141107000241IPhysician AssistantWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98584)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0345139275View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)CA
Interventional Cardiology, Cardiovascular Disease (Cardiology), Interventional CardiologyAK
-WA
Certified Registered Nurse Anesthetist (Crna)MN
Physician AssistantVA
O B S T E T R I C S/ G Y N E C O L O G YWA
Physician AssistantWA
Nurse PractitionerPA
Physician AssistantWA
Physician AssistantWA

Reviews

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Frequently asked questions

Is KC GRAHAM (PA-C) listed with a National Provider Identifier?
Yes — KC GRAHAM (PA-C) has NPI 1467857532 on file in the registry.
Active or inactive — what applies to KC GRAHAM (PA-C)?
You should see KC GRAHAM (PA-C) as active in CMS-hosted NPPES data.
What expertise is attributed to KC GRAHAM (PA-C)?
KC GRAHAM (PA-C)'s specialty line reads Physician Assistant. Clinical services aligned with this taxonomy classification.
What locale is associated with KC GRAHAM (PA-C)?
Directory geography for KC GRAHAM (PA-C) centers on Shelton, Washington.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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