Corey Kendall Graham, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

2100 W Hudson Rd
Rogers, AR 72756-2102

Phone

(479) 340-1100

NPI assigned

Apr 6, 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)

Enrolled

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

{
    "created_epoch": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1124657705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 W HUDSON RD",
            "address_2": "STE 3",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727562181",
            "telephone_number": "407-479-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 W HUDSON RD",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727562102",
            "telephone_number": "479-340-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "COREY",
        "middle_name": "KENDALL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-06",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristi Tennille Gorman, D.D.S
• Emily Elaine Goucher, APRN, WHNP-BC
• Lindsey Ann Goucher, APRN
• GPB Enterprises LLC
• Alyssa Eden Graff, PA
• Alexa Blaire Grand, PA-C
• Phebe Joy Granderson, CNM
• Grant J Fowler D.D.S.
• Patrick Michael Grant Jr.
• Kelly B Gray, LCSW

• Physical Therapist in Rogers, AR
• Providers in Rogers, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; 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.