Organization Active NPI

Walter M. Graham, M.D.

  • Family Medicine Physician
  • Burley, ID
National Provider Identifier
1255296109
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WALTER M. GRAHAM, M.D.
Practice address
32 S 150 E
Burley, ID 83318-5450
Phone
(208) 677-3034
Fax
(208) 677-2483
NPI assigned
Dec 22, 2025
Last updated
Dec 22, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Authorized official

Name
Dr. Walter Maitland Graham, MDNPI 1821031758
Title
Physician
Phone
(208) 677-3034

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

32 S 150 E
Burley, ID 83318-5450

Mailing address

32 S 150 E
Burley, ID 83318-5450
Phone (208) 677-3034

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
13D2299912Walter M Graham MD32 S 150 E, Burley, ID 83318Certificate of waiverFeb 28, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1766361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766361600000",
    "number": "1255296109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 S 150 E",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833185450",
            "telephone_number": "208-677-3034",
            "fax_number": "208-677-2483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 S 150 E",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833185450",
            "telephone_number": "208-677-3034",
            "fax_number": "208-677-2483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTER M. GRAHAM, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-22",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "MAITLAND",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "208-677-3034",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burley, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.