Individual provider Active NPI

Jeffrey Ryan Graves

  • Pharmacist
  • Schenectady, NY
National Provider Identifier
1275913741
Registry record updated May 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
059010-1 Issued in NY
Practice address
461 Nott St
Schenectady, NY 12308-1812
Phone
(518) 355-5000
NPI assigned
May 31, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 059010-1 NY Primary
Pharmacist 183500000X 033.0101708 VT
Pharmacist 183500000X 7000548-01701 UT

Addresses

Primary practice location

461 Nott St
Schenectady, NY 12308-1812

Mailing address

544 Lakeview Rd
Broadalbin, NY 12025-2200
Phone (801) 803-1819

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
059010-1NYMDPharmacist
7000548-01701UTMDPharmacist
033.0101708VTMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1433030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433030400000",
    "number": "1275913741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "544 LAKEVIEW RD",
            "city": "BROADALBIN",
            "state": "NY",
            "postal_code": "120252200",
            "telephone_number": "801-803-1819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 NOTT ST",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123081812",
            "telephone_number": "518-355-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "JEFFREY",
        "middle_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-31",
        "last_updated": "2015-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "059010-1",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VT",
            "license": "033.0101708",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "7000548-01701",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schenectady, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2015; 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.