Individual provider Active NPI

Timothy M. Graham, DPM

  • Foot & Ankle Surgery Podiatrist
  • Belpre, OH
National Provider Identifier
1386055614
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
36003865 Issued in OH
Practice address
2434 Richmiller LN Unit C
Belpre, OH 45714-1075
Phone
(740) 423-3207
Fax
(740) 423-3227
NPI assigned
May 8, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X PO3776 FL
Foot & Ankle Surgery Podiatrist 213ES0103X 36003865 OH Primary

Addresses

Primary practice location

2434 Richmiller LN Unit C
Belpre, OH 45714-1075

Mailing address

805 Farson St Ste 113
Belpre, OH 45714-1000
Phone (740) 423-3207

Other practice location 1

401 Matthew St
Marietta, OH 45750-1635
Phone (740) 374-1623

Other identifiers 1

IdentifierTypeStateIssuer
02060385MedicaidOH

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address timothy.graham@mmhs.medicity.net
Direct Messaging Address timothy.graham@mmhs.medicity.net
Direct Messaging Address timothy.graham@mmhs.medicity.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180316001943 OH Practitioner - Podiatry 5193087823 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Barry University School of Podiatric Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Marietta Memorial HospitalGroup PAC ID 8224928965, 387 clinicians

Practice addresses (Care Compare)

805 Farson St
Suite 113
Belpre, OH 45714-1000
Phone (740) 401-1930

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue123
Removal of skin lesions1-10
Removal of nail tissue24
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO3776FLMDFoot & Ankle Surgery Podiatrist
36003865OHMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Marietta Memorial Hospital CurrentSince May 1, 2018 Accepting new patients
Marietta Memorial Hospital CurrentSince May 1, 2018 Accepting new patients
Selby General Hospital CurrentSince Jan 1, 2026 Accepting new patients
Selby General Hospital CurrentSince Jan 1, 2026 Accepting new patients
Marietta Memorial Hospital Past Accepting new patients

Locations

807 Farson St
Ste 204C
Belpre, OH 45714
Phone (740) 423-3207

2434 Richmiller Ln
Unit C
Belpre, OH 45714
Phone (740) 315-1030

805 Farson St
Ste 113
Belpre, OH 45714
Phone (740) 401-1930

401 Matthew St
Marietta, OH 45750
Phone (740) 374-1400

400 Matthew St
Ste 208
Marietta, OH 45750
Phone (740) 373-5410

701 Hildreth Ln
Marietta, OH 45750
Phone (740) 371-7194

1106 Colegate Dr
Marietta, OH 45750
Phone (740) 374-7700

400 Matthew St
Ste 101
Marietta, OH 45750
Phone (740) 568-4150

Organizations & group practices 5

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

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": "1399507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1386055614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 FARSON ST STE 113",
            "city": "BELPRE",
            "state": "OH",
            "postal_code": "457141000",
            "telephone_number": "740-423-3207",
            "fax_number": "740-423-3227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2434 RICHMILLER LN UNIT C",
            "city": "BELPRE",
            "state": "OH",
            "postal_code": "457141075",
            "telephone_number": "740-423-3207",
            "fax_number": "740-423-3227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 Matthew St",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "OH",
            "postal_code": "457501635",
            "country_code": "US",
            "telephone_number": "740-374-1623",
            "fax_number": "740-568-5355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "TIMOTHY",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-08",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO3776",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "36003865",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02060385",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "timothy.graham@mmhs.medicity.net",
            "affiliation": "N",
            "address_1": "401 Matthew St",
            "city": "Marietta",
            "state": "OH",
            "country_code": "US",
            "postal_code": "457501635",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "timothy.graham@mmhs.medicity.net",
            "affiliation": "N",
            "address_1": "807 Farson St Ste 204C",
            "city": "Belpre",
            "state": "OH",
            "country_code": "US",
            "postal_code": "457141069",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "timothy.graham@mmhs.medicity.net",
            "affiliation": "N",
            "address_1": "2434 Richmiller Ln Unit C",
            "city": "Belpre",
            "state": "OH",
            "country_code": "US",
            "postal_code": "457141075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Belpre, OH

Sources for this page

Verify at the official NPI Registry.