Individual provider Active NPI

Michael Alan Graves, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Conroe, TX
National Provider Identifier
1437692282
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP132317 Issued in TX
Practice address
96 Beach Walk Blvd Ste 208
Conroe, TX 77304-4549
Phone
(281) 393-4692
NPI assigned
Nov 28, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP132317 TX Primary

Addresses

Primary practice location

96 Beach Walk Blvd Ste 208
Conroe, TX 77304-4549

Mailing address

96 Beach Walk Blvd Ste 208
Conroe, TX 77304-4549
Phone (281) 393-4692

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190315000217 TX Practitioner - Nurse Practitioner 8426398108 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

96 Beach Walk Blvd
Suite 208
Conroe, TX 77304-4549
Phone (281) 393-4692

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Develop Counseling & Consulting Services LLC CurrentSince Mar 9, 2022 Accepting new patients
Athi P Venkatesh MD PA CurrentSince Jul 21, 2020 Accepting new patients
Lakeside Mental Health PLLC Psychiatric/Mental Health CurrentSince Nov 11, 2021 Accepting new patients

Locations

96 Beach Walk Blvd
Ste 208
Conroe, TX 77304
Phone (281) 393-4692

19701 Kingwood Dr
Bldg 3
Kingwood, TX 77339
Phone (281) 358-5701

150 Pine Forest Dr
Ste 108
Shenandoah, TX 77384
Phone (281) 358-5701

Organizations & group practices 3

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": "1480291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1437692282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 BEACH WALK BLVD STE 208",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773044549",
            "telephone_number": "281-393-4692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 BEACH WALK BLVD STE 208",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773044549",
            "telephone_number": "281-393-4692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "MICHAEL",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-11-28",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP132317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.