Individual provider Active NPI

Deric Graft

  • Gerontology Occupational Therapist
  • Columbus, OH
National Provider Identifier
1457825614
Registry record updated Jan 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Occupational TherapistTaxonomy code 225XG0600X
License
008538 Issued in OH
Practice address
717 Neil Ave
Columbus, OH 43215-1609
Phone
(614) 228-8888
NPI assigned
Jan 21, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225XG0600X 008538 OH Primary

Addresses

Primary practice location

717 Neil Ave
Columbus, OH 43215-1609

Mailing address

10133 Sherrill Blvd Ste 200
Knoxville, TN 37932-3347

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

State licenses

LicenseStateTypeSpecialty
008538OHMDGerontology Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1548028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548028800000",
    "number": "1457825614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10133 SHERRILL BLVD STE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379323347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 NEIL AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432151609",
            "telephone_number": "614-228-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAFT",
        "first_name": "DERIC",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-21",
        "last_updated": "2019-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Gerontology",
            "state": "OH",
            "license": "008538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2019; 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.