Tracy Graham, O.T.

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT1457 Issued in MS

Practice address

90 Clark Ave # a
Tupelo, MS 38804-2801

Phone

(662) 840-0535

Fax

(662) 842-7915

NPI assigned

Dec 29, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Tri-Vista Rehab, Inc

  • Physical Therapist
  • Tupelo, MS
  • NPI 1982799516

  Occupational Therapist

  NPD (past)
• Tri-Vista Rehab, Inc.

  • Physical Therapist
  • Birmingham, AL
  • NPI 1134540222
  NPD (past)

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386700748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 STARLING CRK",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388293638",
            "telephone_number": "662-416-3283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 CLARK AVE # A",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388042801",
            "telephone_number": "662-840-0535",
            "fax_number": "662-842-7915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "TRACY",
        "name_prefix": "Mr.",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT1457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Cecille Goysich, PSY.D.
• Grace Abounds Home Care
• Gracie PLLC
• Justin C. Graff, M.D.
• Taylor Craven Graham, OTA
• Victoria Ester Graham, DMD
• Grant Family Medical LLC
• Dana Grant, NP-C
• Abby Gravatt, M.S., CCC-SLP
• Amber Graves

• Occupational Therapist in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Occupational Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.