Individual provider Active NPI

Steven Donald Graham, M.D.

  • Specialist
  • Fayetteville, AR
National Provider Identifier
1295713584
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
E-13761 Issued in AR
Practice address
3336 N Futrall Drive
Fayetteville, AR 72703
Phone
(479) 463-3000
Fax
(479) 463-3050
NPI assigned
Jan 6, 2006
Last updated
Jan 19, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD0000019275 TN
Specialist 174400000X E-13761 AR Primary

Addresses

Primary practice location

3336 N Futrall Drive
Fayetteville, AR 72703

Mailing address

PO Box 550
Lowell, AR 72745-0550
Phone (479) 463-7775

Other identifiers 2

IdentifierTypeStateIssuer
3845929MedicaidTN
4062895OtherTNBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20201231001146 AR Practitioner - Neurology 3375687403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Alabama School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3336 N Futrall Dr
NW Arkansas Neuroscience Institute
Fayetteville, AR 72703-4057
Phone (479) 463-3000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD0000019275TNMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Regional Medical System CurrentSince Dec 1, 2020 Accepting new patients
Washington Regional Medical System CurrentSince Dec 1, 2020 Accepting new patients
Centennial Heart LLC Specialist PastSince Aug 18, 2023 Accepting new patients

Locations

114 E Sunbridge Dr
Fayetteville, AR 72703
Phone (479) 463-2597

3336 N Futrall Dr
Fayetteville, AR 72703
Phone (479) 444-8827

Interoperability endpoints

  • Direct secure messaging: sgraham30196@washingtonregional.direct-ci.com
  • Direct secure messaging: stevengraham@wrms.allscriptsdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1295713584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727450550",
            "telephone_number": "479-463-7775",
            "fax_number": "479-463-7187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3336 N FUTRALL DRIVE",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "72703",
            "telephone_number": "479-463-3000",
            "fax_number": "479-463-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "STEVEN",
        "middle_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "MD0000019275",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AR",
            "license": "E-13761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3845929",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4062895",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

Verify at the official NPI Registry.