Individual provider Active NPI

Brian Michael Graf, PT ATC

  • Physical Therapist
  • Brentwood, MO
National Provider Identifier
1154431278
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2003003705 Issued in MO
Practice address
2937 S Brentwood Blvd
Brentwood, MO 63144-2713
Phone
(314) 961-3804
Fax
(314) 961-1147
NPI assigned
Aug 30, 2006
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2003003705 MO Primary

Addresses

Primary practice location

2937 S Brentwood Blvd
Brentwood, MO 63144-2713

Mailing address

625 Enterprise Dr
Oak Brook, IL 60523-8813
Phone (630) 575-1980

Other practice location 1

17363 Edison Ave
Chesterfield, MO 63005
Phone (636) 239-9979

Other practice location 2

17363 Edison Ave
Chesterfield, MO 63005
Phone (636) 239-9979

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2003003705MOMDPhysical Therapist

Interoperability endpoints

  • Direct secure messaging: brian.graf.p2@direct.athleticoltd.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1154431278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 ENTERPRISE DR",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605238813",
            "telephone_number": "630-575-1980",
            "fax_number": "630-928-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2937 S BRENTWOOD BLVD",
            "city": "BRENTWOOD",
            "state": "MO",
            "postal_code": "631442713",
            "telephone_number": "314-961-3804",
            "fax_number": "314-961-1147"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17363 Edison Ave",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MO",
            "postal_code": "63005",
            "country_code": "US",
            "telephone_number": "636-239-9979",
            "fax_number": "636-812-0152",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17363 Edison Ave",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MO",
            "postal_code": "63005",
            "country_code": "US",
            "telephone_number": "636-239-9979",
            "fax_number": "636-812-0152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAF",
        "first_name": "BRIAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PT ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2003003705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.