Active NPI
Maqual Renee Graham, PHARM.D.
- Pharmacotherapy Pharmacist
- Blue Springs, MO
National Provider Identifier
1568634632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- 044041
- Practice address
- 3105 SW 19TH St
Blue Springs, MO 64015-7100 - Phone
- (816) 935-1062
- NPI assigned
- Mar 29, 2008
- Last updated
- Mar 29, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 044041 | MO | Primary |
Addresses
Primary practice location
3105 SW 19TH St
Blue Springs, MO 64015-7100
Mailing address
3105 SW 19TH St
Blue Springs, MO 64015-7100
Phone (816) 935-1062
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 044041 | MO | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206748800000",
"number": "1568634632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3105 SW 19TH ST",
"city": "BLUE SPRINGS",
"state": "MO",
"postal_code": "640157100",
"telephone_number": "816-935-1062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3105 SW 19TH ST",
"city": "BLUE SPRINGS",
"state": "MO",
"postal_code": "640157100",
"telephone_number": "816-935-1062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "MAQUAL",
"middle_name": "RENEE",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-29",
"last_updated": "2008-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "MO",
"license": "044041",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blue Springs, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.