Individual provider Active NPI

Zebulon C Graham, PHARMD

  • Pharmacist
  • Idaho Falls, ID
National Provider Identifier
1417694506
Registry record updated Feb 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
P10481 Issued in ID
Practice address
545 Shoup Ave Ste 224
Idaho Falls, ID 83402-3482
Phone
(208) 528-3939
Fax
(208) 216-0230
NPI assigned
May 19, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X P10481 ID Primary
Pharmacist 183500000X PHA-PHA-LIC-117474 MT
Pharmacist 183500000X 4543 WY

Addresses

Primary practice location

545 Shoup Ave Ste 224
Idaho Falls, ID 83402-3482

Mailing address

545 Shoup Ave Ste 224
Idaho Falls, ID 83402-3482
Phone (208) 528-3939

Other practice location 1

2252 Coronado St
Idaho Falls, ID 83404-7552
Phone (208) 317-8867

Other identifiers 1

IdentifierTypeStateIssuer
1368744OtherNABP

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
P10481IDMDPharmacist
PHA-PHA-LIC-117474MTMDPharmacist
4543WYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Mu Concepts LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1652918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770336000000",
    "number": "1417694506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 SHOUP AVE STE 224",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023482",
            "telephone_number": "208-528-3939",
            "fax_number": "208-216-0230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 SHOUP AVE STE 224",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834023482",
            "telephone_number": "208-528-3939",
            "fax_number": "208-216-0230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2252 Coronado St",
            "address_purpose": "LOCATION",
            "city": "Idaho Falls",
            "state": "ID",
            "postal_code": "834047552",
            "country_code": "US",
            "telephone_number": "208-317-8867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "ZEBULON",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-19",
        "last_updated": "2026-02-06",
        "certification_date": "2026-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "ID",
            "license": "P10481",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MT",
            "license": "PHA-PHA-LIC-117474",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WY",
            "license": "4543",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "1368744",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2026; 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.