Calvin Graham, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2464 Issued in NC

Practice address

311-4E Judges Rd
Wilmington, NC 28405-3655

Phone

(910) 791-6767

Fax

(910) 791-6890

NPI assigned

Oct 20, 2005

Last updated

Sep 27, 2011By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Calvin Graham

  • Clinical Psychologist
  • Goldsboro, NC
  • NPI 1225431356
  NPD (past) Authorized official
• Act Medical Group PA

  • Specialist
  • Wilmington, NC
  • NPI 1245219799
  NPD (past)
• Act Medical Group, PA

  • Family Medicine Physician
  • Wilmington, NC
  • NPI 1598982860
  NPD (past)

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1346239399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311-4E JUDGES RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284053655",
            "telephone_number": "910-791-6767",
            "fax_number": "910-791-6890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311-4E JUDGES RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284053655",
            "telephone_number": "910-791-6767",
            "fax_number": "910-791-6890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "CALVIN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "2464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6001099",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "047TU",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grace of Jordan Home Care LLC (Grace of Jordan Home Care)
• Sarah Elizabeth Grady
• Jason Allen Graf, D.C.
• Laura Lynn Graff, M.A., CCC-SLP
• Barbara Graham, MSW, LCSWA
• Eddie Romero Graham, DDS
• Emily Graham, LPCA
• Hayley Watson Graham
• Laura Graham
• Lee Covington Graham, M.A., L.P.A.

• Clinical Psychologist in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; 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.