Jackson Charles Graham, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3224 Issued in OK

Practice address

820 State Line Rd
West Siloam Springs, OK 74338

Phone

(918) 422-5811

NPI assigned

Aug 8, 2023

Last updated

Jul 2, 2025By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dr. Torrey J. Carlson & Associates

  • Optometrist
  • Kingsport, TN
  • NPI 1366480964
  Medicare reassignment NPD
• Insightful Eye & Optical, PLLC

  • Optometrist
  • Gentry, AR
  • NPI 1649169731
  NPD Authorized official
• My Family Eyecare, LTD., P.C.

  • Optometrist
  • Colcord, OK
  • NPI 1487958492
  NPD
• Eye Center, PA

  • Ophthalmology Physician
  • Fayetteville, AR
  • NPI 1629169727

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1691452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751414400000",
    "number": "1497438493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 460",
            "city": "GENTRY",
            "state": "AR",
            "postal_code": "727340460",
            "telephone_number": "918-931-2729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 STATE LINE RD",
            "city": "WEST SILOAM SPRINGS",
            "state": "OK",
            "postal_code": "74338",
            "telephone_number": "918-422-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "JACKSON",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-08",
        "last_updated": "2025-07-02",
        "certification_date": "2025-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2894",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "3224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grand Lake Mental Health Center, Inc (GRAND Mental Health)
• Grand Lake Mental Health Center, Inc. (GRAND Mental Health)
• Aubre Phillips
• Carter Christian Sparks

• Optometrist in West Siloam Springs, OK
• Providers in West Siloam Springs, OK by specialty
• Optometrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.