Cynthia Marie Graham, OTHER

Primary specialty

SpecialistTaxonomy code 174400000X

License

09328513 Issued in MN

Practice address

201 W Burnsville Pkwy
#138
Burnsville, MN 55337-2527

Phone

(952) 890-5607

Fax

(952) 469-8457

NPI assigned

Jun 8, 2010

Last updated

Jun 8, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1275955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275955200000",
    "number": "1497075956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W BURNSVILLE PKWY",
            "address_2": "#138",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553372527",
            "telephone_number": "952-890-5607",
            "fax_number": "952-469-8457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W BURNSVILLE PKWY",
            "address_2": "#138",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553372527",
            "telephone_number": "952-890-5607",
            "fax_number": "952-469-8457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "CYNTHIA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "OTHER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-08",
        "last_updated": "2010-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MN",
            "license": "09328513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Burnsville, MN
• Providers in Burnsville, MN by specialty
• Specialist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2010; 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.