Mary Frances Graham, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

160002054 Issued in IL

Practice address

1901 N. 13TH Street
Herrin, IL 62948

Phone

(618) 942-3274

Fax

(618) 942-8240

NPI assigned

Aug 28, 2008

Last updated

Aug 28, 2008By the provider in NPPES

Sex

Female

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219881600000",
    "number": "1174771422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 N. 13TH STREET",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "62948",
            "telephone_number": "618-942-3274",
            "fax_number": "618-942-8240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 N. 13TH STREET",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "62948",
            "telephone_number": "618-942-3274",
            "fax_number": "618-942-8240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "MARY",
        "middle_name": "FRANCES",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-28",
        "last_updated": "2008-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IL",
            "license": "160002054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chanavia Marquetta Givens
• Terrence Glennon, MD
• Macy Lane Goins, NP
• Robert J Golz, MD
• Marta Gonzales
• Skylyn Elise Gullo
• Stephanie R Gustave, LPC, AMFT
• Zachary R Gustavison, PA-C
• Lori M Guyton, M.D.
• H&S Pharmacies, LLC (MediCenter Pharmacy Logan Primary)

• Physical Therapy Assistant in Herrin, IL
• Providers in Herrin, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2008; 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.