Individual provider Active NPI

Danielle N Graham

  • Optician
  • Inverness, FL
National Provider Identifier
1154903086
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OpticianTaxonomy code 156FX1800X
License
DO7476 Issued in FL
Practice address
2637 E Gulf to Lake Hwy
Inverness, FL 34453-3216
Phone
(352) 637-5180
Fax
(352) 423-1410
NPI assigned
Apr 21, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optician 156FX1800X DO7476 FL Primary

Addresses

Primary practice location

2637 E Gulf to Lake Hwy
Inverness, FL 34453-3216

Mailing address

3404 S Rose PT
Inverness, FL 34450-6307
Phone (352) 422-4712

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DO7476FLMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1154903086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3404 S ROSE PT",
            "city": "INVERNESS",
            "state": "FL",
            "postal_code": "344506307",
            "telephone_number": "352-422-4712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2637 E GULF TO LAKE HWY",
            "city": "INVERNESS",
            "state": "FL",
            "postal_code": "344533216",
            "telephone_number": "352-637-5180",
            "fax_number": "352-423-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "DANIELLE",
        "middle_name": "N",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "FL",
            "license": "DO7476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inverness, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; 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.