Kevin T Graham, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35.096582 Issued in OH

Practice address

1264 Weaver Dr
Granville, OH 43023-1257

Phone

(220) 564-1950

Fax

(220) 564-1951

NPI assigned

Jul 10, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Family Practice

Education

University of Cincinnati College of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Ohio Primary Care Physicians, Inc. 487 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health II Home health agency, Mount Vernon, OH, CCN 368015
• Premier Home Health LLC Home health agency, Newark, OH, CCN 369198
• Licking Memorial Hospital Hospital, Newark, OH, CCN 360218
• James Cancer Hospital & Solove Research Institute Hospital, Columbus, OH, CCN 360242
• Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006

Procedures performed for Medicare patients

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 and National Provider Directory roles.

• Central Ohio Primary Care Physicians, Inc.

  • Internal Medicine Physician
  • Westerville, OH
  • NPI 1194705194

  Family Medicine, OH

  Medicare reassignment Care Compare group NPD
• Central Ohio Primary Care Physicians, Inc.

  • Clinical Medical Laboratory
  • Westerville, OH
  • NPI 1639279045
  Care Compare group NPD
• Licking Memorial Professional Corp.

  • Pediatrics Physician
  • Utica, OH
  • NPI 1497771521
  NPD (past)
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Arthur G James Cancer Hospital and Research Institute

  • Special Hospital
  • Columbus, OH
  • NPI 1124127683

  Hospital

  Care Compare affiliation
• Licking Memorial Hospital

  • General Acute Care Hospital
  • Newark, OH
  • NPI 1568446755

  Hospital

  Care Compare affiliation
• Ohiohealth Corporation

  • General Acute Care Hospital
  • Columbus, OH
  • NPI 1467484972

  Hospital

  Care Compare affiliation
• Ohiohealth Corporation

  • Clinical Medical Laboratory
  • Columbus, OH
  • NPI 1710916945

  Hospital

  Care Compare affiliation
• PF Development 15, LLC

  • Home Health Agency
  • Mount Vernon, OH
  • NPI 1821398447
  Care Compare affiliation
• Premier Home Health,LLC

  • Home Health Agency
  • Newark, OH
  • NPI 1164922191
  Care Compare affiliation

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1457559692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1264 WEAVER DR",
            "city": "GRANVILLE",
            "state": "OH",
            "postal_code": "430231257",
            "telephone_number": "220-564-1950",
            "fax_number": "220-564-1951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1264 WEAVER DR",
            "city": "GRANVILLE",
            "state": "OH",
            "postal_code": "430231257",
            "telephone_number": "220-564-1950",
            "fax_number": "220-564-1951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "KEVIN",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-10",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35.096582",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.096582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3114105",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgraham14349@lickingmemorial.medicity.net",
            "affiliation": "N",
            "address_1": "1264 Weaver Dr",
            "city": "Granville",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430231257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Tanner Lee German
• Caryn Gorby, CNP
• Megan Gordon
• Stacy Gossman, M.A., CCC-SLP
• Granville Chiropractic LLC
• Granville Counseling Center LLC
• Granville Dental - M.Alexandrunas, D.M.D., Inc.
• Granville Dental - M.Alexandrunas, D.M.D., Inc.
• Granville Dental Mark Alexandrunas DMD Inc

• All providers in Granville, OH
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.