Individual provider Active NPI

Terry M Graber, MD

  • Family Medicine Physician
  • Custer, SD
National Provider Identifier
1063465995
Registry record updated Jan 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3475 Issued in SD
Practice address
1041 Montgomery Street
Custer, SD 57730-1304
Phone
(605) 673-4150
Fax
(605) 673-3917
NPI assigned
May 19, 2006
Last updated
Jan 23, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 3475 SD Primary

Addresses

Primary practice location

1041 Montgomery Street
Custer, SD 57730-1304

Mailing address

353 Fairmont Blvd
Atten Medical Staff Services
Rapid City, SD 57701-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060815000116 SD Practitioner - Family Practice 9436189669 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
3475SDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Network, Inc. Family Medicine CurrentSince Jan 13, 2010 Accepting new patients
Monument Health Network, Inc. Family Medicine CurrentSince Aug 17, 2005 Accepting new patients
Monument Health Network, Inc. Current Accepting new patients

Locations

1039 Montgomery St
Custer, SD 57730
Phone (605) 673-2229

1041 Montgomery St
Custer, SD 57730
Phone (605) 662-7250

1220 Montgomery St
Custer, SD 57730
Phone (605) 673-4150

1440 N Main St
Spearfish, SD 57783
Phone (605) 644-4000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358899200000",
    "number": "1063465995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 FAIRMONT BLVD",
            "address_2": "ATTEN MEDICAL STAFF SERVICES",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577016000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 MONTGOMERY STREET",
            "city": "CUSTER",
            "state": "SD",
            "postal_code": "577301304",
            "telephone_number": "605-673-4150",
            "fax_number": "605-673-3917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRABER",
        "first_name": "TERRY",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2013-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "3475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Custer, SD

Sources for this page

Verify at the official NPI Registry.