Individual provider Active NPI

Graham Smith, MD

  • Emergency Medicine Physician
  • Murray, KY
National Provider Identifier
1528006376
Registry record updated Mar 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
29352 Issued in KY
Practice address
803 Poplar St
Murray, KY 42071-2432
Phone
(270) 762-1100
NPI assigned
Jun 3, 2006
Last updated
Mar 10, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 29352 KY Primary

Addresses

Primary practice location

803 Poplar St
Murray, KY 42071-2432

Mailing address

15 Bear Run TRL
Benton, KY 42025-5833

Other identifiers 4

IdentifierTypeStateIssuer
64293525MedicaidKY
P00210552OtherKYRAILROAD MEDICARE
4047215MedicaidTN
000000331843OtherKYBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20040914001163 KY Practitioner - Emergency Medicine 4981671328

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as virtual group
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
29352KYMDEmergency Medicine Physician
29362KYMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205107200000",
    "number": "1528006376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 BEAR RUN TRL",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420255833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 POPLAR ST",
            "city": "MURRAY",
            "state": "KY",
            "postal_code": "420712432",
            "telephone_number": "270-762-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "GRAHAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2008-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "29352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64293525",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00210552",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4047215",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000331843",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, KY

Sources for this page

Verify at the official NPI Registry.