Ketwan Kareem Graham

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P013126 Issued in NC

Practice address

474 N Center St
Statesville, NC 28677-4022

Phone

(704) 873-3491

NPI assigned

Aug 26, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1598400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1043823396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 WEST AVE",
            "city": "TROUTMAN",
            "state": "NC",
            "postal_code": "281668619",
            "telephone_number": "704-746-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "474 N CENTER ST",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286774022",
            "telephone_number": "704-873-3491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "KETWAN",
        "middle_name": "KAREEM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-26",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P013126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gina Cook Gouge, COTA/L
• Harsh Govil, MD, MPH
• GR Vito-Brookdale Foot Clinic
• Grace Home Care Living
• Megann E Grace-Sanchez, MSW, LCSWA
• Kristen Graham
• Landry Schofield Graham, FNP-C
• Brandi Grant, FNP-C
• Lori Greer Gray, RN
• Olga V Gray, FNP

• Clinical Social Worker in Statesville, NC
• Providers in Statesville, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.