Individual provider Active NPI

Micheal David Graves, LPN

  • Licensed Practical Nurse
  • Youngstown, OH
National Provider Identifier
1174234868
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN.092670.MEDS Issued in OH
Practice address
1815 Belmont Ave.
Youngstown, OH 44504
Phone
(330) 740-9200
NPI assigned
Dec 13, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN.092670.MEDS OH Primary

Addresses

Primary practice location

1815 Belmont Ave.
Youngstown, OH 44504

Mailing address

1815 Belmont Ave.
Youngstown, OH 44504
Phone (330) 740-9200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address michael.graves2@va.gov Direct

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
LPN.092670.MEDSOHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1670889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1174234868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 BELMONT AVE.",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "44504",
            "telephone_number": "330-740-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 BELMONT AVE.",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "44504",
            "telephone_number": "330-740-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "MICHEAL",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-13",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "LPN.092670.MEDS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "michael.graves2@va.gov",
            "affiliation": "N",
            "endpointDescription": "Government email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Government email address",
            "address_1": "1815 Belmont Ave",
            "city": "Youngstown",
            "state": "OH",
            "country_code": "US",
            "postal_code": "44504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.