Matthew Duane Graham, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

02003335A Issued in IN

Practice address

77 Nealy Ave
Langley Afb, VA 23665-2040

Phone

(701) 723-5112

NPI assigned

Nov 30, 2006

Sex

Male

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

Enrolled in ND

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1275601320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 ELM ST",
            "city": "LANGLEY AFB",
            "state": "VA",
            "postal_code": "236652008",
            "telephone_number": "757-225-0956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 NEALY AVE",
            "city": "LANGLEY AFB",
            "state": "VA",
            "postal_code": "236652040",
            "telephone_number": "701-723-5112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "MATTHEW",
        "middle_name": "DUANE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02003335A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristopher J. Filak, M.D.
• Robert Joseph Fischer, M.D.
• Samuel Matthew Fowler, DMD
• Nathan Michael Fritz
• Cubby L Gardner, FNP-C
• Rhonda McClinton Graves
• Amanda Kanwischer Gutierrez, O.D.
• Steven Kyle Hammond I
• Maureen Oliver Harback, R.D.
• Stephen Mitchell Harris, IDMT

• Family Medicine Physician in Langley Afb, VA
• Providers in Langley Afb, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.