Mary L Graeff, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

31257 Issued in IA

Practice address

509 N Madison St
Bloomfield, IA 52537-1271

Phone

(641) 664-3832

Fax

(641) 664-1857

NPI assigned

Aug 30, 2005

Last updated

Feb 10, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Mary L Dammen Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Davis County Hospital

  • Specialist
  • Bloomfield, IA
  • NPI 1487740486
  Medicare reassignment NPD
• Davis County Hospital

  dba Davis County Medical Associates

  • Rural Health Clinic/Center
  • Bloomfield, IA
  • NPI 1821413667
  NPD

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612915200000",
    "number": "1396738902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 N MADISON ST",
            "city": "BLOOMFIELD",
            "state": "IA",
            "postal_code": "525371271",
            "telephone_number": "641-664-3832",
            "fax_number": "641-664-1857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 N MADISON ST",
            "city": "BLOOMFIELD",
            "state": "IA",
            "postal_code": "525371271",
            "telephone_number": "641-664-3832",
            "fax_number": "641-664-1857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAEFF",
        "first_name": "MARY",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "31257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK INC BCBS",
            "identifier": "40065",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIWEST",
            "identifier": "G009",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0155812",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE HEALTH",
            "identifier": "42063106052",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH SOLUTIONS",
            "identifier": "37876",
            "state": "IA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgraeff@davis.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "DCMA@davis.cernerdirect.com",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "509 N Madison St",
            "city": "Bloomfield",
            "state": "IA",
            "country_code": "US",
            "postal_code": "525371271",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "DAMMEN",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Pediatrics Physician in Bloomfield, IA
• Providers in Bloomfield, IA by specialty
• Pediatrics Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.