Active NPI
Leroy Graham Jr., MD
- Family Medicine Physician
- Newport News, VA
National Provider Identifier
1043325434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 0101229881
- Practice address
- 15408 Warwick Blvd
Newport News, VA 23608-1576 - Phone
- (757) 890-0012
- Fax
- (757) 890-0013
- NPI assigned
- Aug 19, 2006
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0101229881 | VA | Primary |
Addresses
Primary practice location
15408 Warwick Blvd
Newport News, VA 23608-1576
Mailing address
15408 Warwick Blvd
Newport News, VA 23608-1576
Phone (757) 890-0012
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 76157 | Other | VA | OPTIMA |
| 2126544 | Other | VA | MDIPA |
| 145933 | Other | VA | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Salters Creek Medical Group | Family Medicine | Current | Accepting new patients |
Locations
183 Woodland Rd
Hampton, VA 23663
Phone (757) 723-1899
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197590400000",
"number": "1043325434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15408 WARWICK BLVD",
"city": "NEWPORT NEWS",
"state": "VA",
"postal_code": "236081576",
"telephone_number": "757-890-0012",
"fax_number": "757-890-0013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15408 WARWICK BLVD",
"city": "NEWPORT NEWS",
"state": "VA",
"postal_code": "236081576",
"telephone_number": "757-890-0012",
"fax_number": "757-890-0013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "LEROY",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-19",
"last_updated": "2007-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "VA",
"license": "0101229881",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTIMA",
"identifier": "76157",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MDIPA",
"identifier": "2126544",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "145933",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newport News, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.