Ian R Graham, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

2002015742 Issued in MO

Practice address

Henry County Medical Center
301 Tyson Avenue
Paris, TN 38424

Phone

(731) 644-8535

Fax

(731) 642-9588

NPI assigned

Jul 14, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Pemiscot County Memorial Hospital

  • Emergency Care Clinic/Center
  • Hayti, MO
  • NPI 1578668661

  MO

  Medicare reassignment NPD
• USA Radiology Management Solutions LLC

  • Diagnostic Radiology Physician
  • Rolla, MO
  • NPI 1689091076

  Diagnostic Radiology, MO

  Medicare reassignment NPD
• USA Radiology of Pennsylvania, LLC

  • Body Imaging Physician
  • Meadville, PA
  • NPI 1164907655

  MO

  Medicare reassignment
• Pemiscot County Memorial Hospital

  • Rural Acute Care Hospital
  • Hayti, MO
  • NPI 1437179710
  NPD
• Boonslick Medical Group Inc

  • Diagnostic Radiology Physician
  • Saint Charles, MO
  • NPI 1972666162

  Diagnostic Radiology

  NPD (past)
• Radiologic Imaging Consultants, LLP

  • Diagnostic Radiology Physician
  • St Charles, MO
  • NPI 1871689505

  Diagnostic Radiology

  NPD (past)

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1528084464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2153 DEPT 30755",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352879283",
            "telephone_number": "314-238-5260",
            "fax_number": "314-821-1833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HENRY COUNTY MEDICAL CENTER",
            "address_2": "301 TYSON AVENUE",
            "city": "PARIS",
            "state": "TN",
            "postal_code": "38424",
            "telephone_number": "731-644-8535",
            "fax_number": "731-642-9588"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4750 Mexico Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Peters",
            "state": "MO",
            "postal_code": "633761668",
            "country_code": "US",
            "telephone_number": "636-498-4555",
            "fax_number": "636-498-2555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "IAN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036107429",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2002015742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE NUMBER",
            "identifier": "300133434",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "205942303",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Virginia Go, MD
• Linda Rhea Goddard, CERT.PHARMTECH
• Donald D. Gold Jr., M.D.
• Brian Golden, LADAC
• Keith Randall Gould, DO
• James C Graves, D.D.S
• Lori Gream, FNP
• Amanda Ren'a Greene, OT
• Andrzej Marek Greziak, PT
• Walter P. Griffey III, M.D.

• All providers in Paris, TN
• Diagnostic Radiology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; 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.