Active NPI
Dennis Graham, D.O.
- Orthopaedic Surgery Physician
- Stephenville, TX
National Provider Identifier
1619972221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- F6684
- Practice address
- 150 River North Blvd
Stephenville, TX 76401-1803 - Phone
- (254) 968-6051
- Fax
- (254) 968-4204
- NPI assigned
- Jun 20, 2005
- Reactivated
- Mar 17, 2009
- 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 |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | F6684 | TX | Primary |
Addresses
Primary practice location
150 River North Blvd
Stephenville, TX 76401-1803
Mailing address
150 River North Blvd
Stephenville, TX 76401-1803
Phone (254) 968-6051
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 141204101 | Medicaid | TX | TEXAS PROVIDER IDENTIFIER |
| 8978M0 | Other | TX | BCBS PROVIDER NUMBER |
| 113891100 | Other | TN | FIRST CARE PROVIDER NUMBE |
| 200040612 | Other | TX | RAILROAD MEDICARE |
| 206304301 | Other | TX | UNITED HEALTHCARE PROV NO |
| 6300665002 | Other | TX | CIGNA PROVIDER NUMBER |
| 7182209 | Other | TX | AETNA PROVIDER NUMBER |
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F6684 | TX | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252022400000",
"number": "1619972221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 RIVER NORTH BLVD",
"city": "STEPHENVILLE",
"state": "TX",
"postal_code": "764011803",
"telephone_number": "254-968-6051",
"fax_number": "254-968-4204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 RIVER NORTH BLVD",
"city": "STEPHENVILLE",
"state": "TX",
"postal_code": "764011803",
"telephone_number": "254-968-6051",
"fax_number": "254-968-4204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "DENNIS",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-20",
"last_updated": "2009-09-04",
"deactivation_date": "2005-09-27",
"reactivation_date": "2009-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "TX",
"license": "F6684",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": "TEXAS PROVIDER IDENTIFIER",
"identifier": "141204101",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NUMBER",
"identifier": "8978M0",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST CARE PROVIDER NUMBE",
"identifier": "113891100",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "200040612",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE PROV NO",
"identifier": "206304301",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA PROVIDER NUMBER",
"identifier": "6300665002",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PROVIDER NUMBER",
"identifier": "7182209",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stephenville, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.