Trevor Graves

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

904352-4405 Issued in UT

Practice address

4401 Harrison Blvd
Ogden, UT 84403-3195

Phone

(801) 387-4300

Fax

(801) 387-4306

NPI assigned

Dec 18, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1376311480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 HARRISON BLVD",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033195",
            "telephone_number": "801-387-4300",
            "fax_number": "801-387-4306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "TREVOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-18",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "UT",
            "license": "11588995-3102",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "UT",
            "license": "904352-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Z Graff
• Joseph E Graham, MD
• Stanley Tanner Graham, M.D.
• Michael Ramit Grant, MD
• Gratitude Counseling Services
• Bryan Gray, CMHC
• Carl R Gray, M.D.
• Chad Gray
• Greater Health of Northern Utah
• Tiffanee Greathouse

• Neonatal Nurse Practitioner in Ogden, UT
• Providers in Ogden, UT by specialty
• Neonatal Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; 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.