Jon Henry Graham III, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

726148 Issued in NY

Practice address

75 Camp St
Apt 1
Providence, RI 02906-1739

Phone

(617) 733-9303

NPI assigned

Apr 26, 2017

Last updated

May 10, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1493164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494374400000",
    "number": "1417482514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 CAMP ST",
            "address_2": "APT 1",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029061739",
            "telephone_number": "617-733-9303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 CAMP ST",
            "address_2": "APT 1",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029061739",
            "telephone_number": "617-733-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "JON",
        "middle_name": "HENRY",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-26",
        "last_updated": "2017-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2279317",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95064157",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "726148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Grabert, L.M.H.C.
• Carrollyn E Grace, APRN PCNS
• Alanna Guilbeault Gracia, OTR/L
• Shilpa Vijayakumar Gracia, MD
• Lisa Grady, D.O.
• Kirsten Graham, OD
• Carolyn Patricia Granata
• Julie Francine Grand-Landau, LICSW
• David Grand, M.D.
• Sandy Grand, PHD

• Registered Nurse in Providence, RI
• Providers in Providence, RI by specialty
• Registered Nurse in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2017; 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.