Active NPI
Leroy Clarence Graham, R.PH
- Pharmacist
- Nevada, MO
National Provider Identifier
1376816389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 027882
- Practice address
- 125 S Washington St
Nevada, MO 64772-3329 - Phone
- (816) 732-5514
- NPI assigned
- Feb 22, 2012
- Last updated
- Feb 22, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 027882 | MO | Primary |
Addresses
Primary practice location
125 S Washington St
Nevada, MO 64772-3329
Mailing address
5322 W. 141St Terr
Leawood, KS 66224-1157
Phone (913) 608-5411
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 18350000X | Other | MO | PHARMACIST |
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 027882 | MO | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329868800000",
"number": "1376816389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5322 W. 141ST TERR",
"city": "LEAWOOD",
"state": "KS",
"postal_code": "662241157",
"telephone_number": "913-608-5411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 S WASHINGTON ST",
"city": "NEVADA",
"state": "MO",
"postal_code": "647723329",
"telephone_number": "816-732-5514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "LEROY",
"middle_name": "CLARENCE",
"credential": "R.PH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-02-22",
"last_updated": "2012-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MO",
"license": "027882",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST",
"identifier": "18350000X",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nevada, MO
- Friendship House
- Full Health Wellness Systems
- Weston Drew Fulmer, DMD
- Emily Kaye Gallup
- Scott M Gibbs, PA
- Melissa Gratton, RN
- Great Plains Hospital (Heartland Behavioral)
- Great Plains Hospital (Heartland Behavioral)
- Great Plains Hospital (Heartland Hospital)
- Great Plains Hospital (Heartland Behavioral)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.