Active NPI
Bethany Nicole Graham
- Speech-Language Pathologist
- Columbus, IN
National Provider Identifier
1194269472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 46003089A
- Practice address
- 4610 25TH St
Columbus, IN 47203-3239 - Phone
- (812) 314-2378
- NPI assigned
- Dec 6, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 46003089A | IN | Primary |
Addresses
Primary practice location
4610 25TH St
Columbus, IN 47203-3239
Mailing address
4610 25TH St
Columbus, IN 47203-3239
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
| License | State | Type | Specialty |
|---|---|---|---|
| 46003089A | IN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1480982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481500800000",
"number": "1194269472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4610 25TH ST",
"city": "COLUMBUS",
"state": "IN",
"postal_code": "472033239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4610 25TH ST",
"city": "COLUMBUS",
"state": "IN",
"postal_code": "472033239",
"telephone_number": "812-314-2378"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "BETHANY",
"middle_name": "NICOLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-12-06",
"last_updated": "2016-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "46003089A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.