Ted Graham, MD

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

R0007 Issued in TX

Practice address

3134 Briarcrest Dr
Bryan, TX 77802-3014

Phone

(979) 314-2323

NPI assigned

Jun 9, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Kentuckiana Emergency Physicians

  • Emergency Care Clinic/Center
  • Louisville, KY
  • NPI 1942362058
  NPD (past)
• Kentuckiana Emergency Physicians, PLLC

  • Emergency Medicine Physician
  • Louisville, KY
  • NPI 1801833140

  Emergency Medical Services

  NPD (past)
• Louisville Radiology Imaging Consultants, PLLC

  • Diagnostic Radiology Physician
  • Owensboro, KY
  • NPI 1639115447
  NPD (past)

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586304000000",
    "number": "1093756249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4308 ODELL LN",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778457350",
            "telephone_number": "910-724-2194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3134 BRIARCREST DR",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778023014",
            "telephone_number": "979-314-2323"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 Memorial Dr",
            "address_purpose": "LOCATION",
            "city": "Pinehurst",
            "state": "NC",
            "postal_code": "283748710",
            "country_code": "US",
            "telephone_number": "910-715-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "TED",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "TX",
            "license": "R0007",
            "primary": true
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NC",
            "license": "200000436",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891261N",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia Ann Gosnell, PH.D.
• Michael Allen Gotowka, PSY.D.
• Kathryn Gowers, PA-C
• Grace Wellness Center
• Grace Wellness PLLC
• Dalton Grahmann, PHARMACIST INTERN
• Amanda Pasley Gray, LPC
• Billy T Gray, PA
• Brent Morgan Gray, M.D.
• Bri Amos Gray, DO

• Emergency Medical Services (Emergency Medicine) Physician in Bryan, TX
• Providers in Bryan, TX by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2020; 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.

Verify at the official NPI Registry.