Active NPI
Luanna Graeber, PA-C
- Medical Physician Assistant
- Garrison, ND
National Provider Identifier
1609846823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PAC0029
- Practice address
- 437 3Rd Ave SE
Garrison, ND 58540-7235 - Phone
- (701) 463-2245
- Fax
- (701) 463-6543
- NPI assigned
- Jan 23, 2006
- Last updated
- Oct 10, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PAC0029 | ND | Primary |
Addresses
Primary practice location
437 3Rd Ave SE
Garrison, ND 58540-7235
Mailing address
PO Box 9
Garrison, ND 58540-0009
Phone (701) 463-2245
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20686 | Other | ND | BLUECROSS/BLUE SHIELD |
| 12635 | Medicaid | ND |
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
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191974400000",
"number": "1609846823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9",
"city": "GARRISON",
"state": "ND",
"postal_code": "585400009",
"telephone_number": "701-463-2245",
"fax_number": "701-463-6543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "437 3RD AVE SE",
"city": "GARRISON",
"state": "ND",
"postal_code": "585407235",
"telephone_number": "701-463-2245",
"fax_number": "701-463-6543"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAEBER",
"first_name": "LUANNA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-23",
"last_updated": "2007-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "ND",
"license": "PAC0029",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS/BLUE SHIELD",
"identifier": "20686",
"state": "ND"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "12635",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}Other providers in Garrison, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.