Douglas Graham, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

002264 Issued in NY

Practice address

1 Saxon Dr McLane Center
Alfred, NY 14802-1205

Phone

(607) 871-3495

NPI assigned

Sep 24, 2013

Sex

Male

Sole proprietor

No

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.

• Alfred University

  • Family Medicine Physician
  • Alfred, NY
  • NPI 1033511787
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 24, 2013.

{
    "created_epoch": "1379980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379980800000",
    "number": "1447686332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SAXON DR MCLANE CENTER",
            "city": "ALFRED",
            "state": "NY",
            "postal_code": "148021205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SAXON DR MCLANE CENTER",
            "city": "ALFRED",
            "state": "NY",
            "postal_code": "148021205",
            "telephone_number": "607-871-3495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "DOUGLAS",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-24",
        "last_updated": "2013-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "002264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca C. Dennis, FNP
• Nancy Jo Evangelista, PH.D.
• Family Medical Health of Alfred, PLLC
• Gerard M. Gingras, ATC
• Liam Patrick Glover, MBA, ATC
• Geremy Kristan Grant, PHD
• Judith L. Grant, ANP
• Anthony Joseph Graziano, R.PH.
• Sherry S Herdman, M.S, FNP, CDE
• Del Rey Honeycutt

• All providers in Alfred, NY
• Athletic Trainer in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2013; 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.