Active NPI
Robert William Graham, P T
- Physical Therapist
- Beachwood, OH
National Provider Identifier
1578782629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 000940
- Practice address
- 23900 Chagrin Blvd
Beachwood, OH 44122-5511 - Phone
- (216) 464-1000
- NPI assigned
- Apr 25, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 000940 | OH | Primary |
Addresses
Primary practice location
23900 Chagrin Blvd
Beachwood, OH 44122-5511
Mailing address
10722 Chillicothe Rd
Kirtland, OH 44094-5101
Phone (440) 256-1626
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000940 | OH | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Atlantis Physical Therapy Assoc | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1578782629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10722 CHILLICOTHE RD",
"city": "KIRTLAND",
"state": "OH",
"postal_code": "440945101",
"telephone_number": "440-256-1626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23900 CHAGRIN BLVD",
"city": "BEACHWOOD",
"state": "OH",
"postal_code": "441225511",
"telephone_number": "216-464-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "ROBERT",
"middle_name": "WILLIAM",
"name_prefix": "Mr.",
"credential": "P T",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "000940",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beachwood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.