Gary R Graham, MD

Primary specialty

Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X

License

39362 Issued in CO

Practice address

4605 Belford Cir
Broomfield, CO 80023-8110

Phone

(720) 234-2682

NPI assigned

Jul 28, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577491200000",
    "number": "1477567170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4605 BELFORD CIR",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800238110",
            "telephone_number": "720-234-2682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 BELFORD CIR",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800238110",
            "telephone_number": "720-234-2682"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5150 E Pacific Coast Hwy",
            "address_2": "500",
            "address_purpose": "LOCATION",
            "city": "Long Beach",
            "state": "CA",
            "postal_code": "908043312",
            "country_code": "US",
            "telephone_number": "720-234-2682",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "GARY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2019-12-28",
        "certification_date": "2019-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "CA",
            "license": "C 51164",
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "CO",
            "license": "39362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "92828540",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Gorski, PT
• Lesley Rachel Goth, PSYD
• Rahil Gour, DO
• Daniel Gracey, PT
• Colleen P Grady, FNP
• Deborah Granberg, MSPT
• Osvaldo Gratacos, D.C.
• Eric Anthony Graves, D.C.
• Timothy Graves, DC
• Jennifer A Gray, M.S., CCC-SLP

• Hospice and Palliative Medicine (Family Medicine) Physician in Broomfield, CO
• Providers in Broomfield, CO by specialty
• Hospice and Palliative Medicine (Family Medicine) Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.