Active NPI
Susan R Graham, C.N.M.
- Advanced Practice Midwife
- Chinle, AZ
National Provider Identifier
1043263296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- 000570
- Practice address
- Highway 191 Hospital Drive
Chinle, AZ 86503 - Phone
- (518) 944-9660
- NPI assigned
- May 18, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | 000570 | NY | Primary |
Addresses
Primary practice location
Highway 191 Hospital Drive
Chinle, AZ 86503
Mailing address
PO Box 1569
Chinle, AZ 86503-1569
Phone (518) 944-9660
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01780198 | Medicaid | NY |
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)
- Enrolled
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 570 | NY | MD | Audiologist |
| 000570 | NY | MD | Advanced Practice Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391126400000",
"number": "1043263296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1569",
"city": "CHINLE",
"state": "AZ",
"postal_code": "865031569",
"telephone_number": "518-944-9660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "HIGHWAY 191 HOSPITAL DRIVE",
"city": "CHINLE",
"state": "AZ",
"postal_code": "86503",
"telephone_number": "518-944-9660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "SUSAN",
"middle_name": "R",
"credential": "C.N.M.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-18",
"last_updated": "2014-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "NY",
"license": "000570",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01780198",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chinle, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.