Active NPI
Timothy Graham
- Peer Specialist
- St Petersburg, FL
National Provider Identifier
1023939550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- CRPS.0101354.V
- Practice address
- 4024 Central Ave
St Petersburg, FL 33711-1239 - Phone
- (727) 327-7656
- NPI assigned
- Jul 22, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | CRPS.0101354.V | FL | Primary |
Addresses
Primary practice location
4024 Central Ave
St Petersburg, FL 33711-1239
Mailing address
1640 Clearwater Largo Rd Apt 207
Clearwater, FL 33756-2539
Phone (727) 327-7656
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1784678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784678400000",
"number": "1023939550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1640 CLEARWATER LARGO RD APT 207",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337562539",
"telephone_number": "727-327-7656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4024 CENTRAL AVE",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337111239",
"telephone_number": "727-327-7656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "TIMOTHY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-07-22",
"last_updated": "2026-07-22",
"certification_date": "2026-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "FL",
"license": "CRPS.0101354.V",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.