Robert Wallace Graham, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

4438 Issued in IA

Practice address

800 Mercy Dr
Council Bluffs, IA 51503-3128

Phone

(800) 875-0136

Fax

(937) 619-4150

NPI assigned

Mar 27, 2010

Last updated

Jun 3, 2013By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in NE, UT2 enrollments

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 2

Specialty

Emergency Medicine

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Physicians Integrated Care LLCGroup PAC ID 4284548116, 203 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lakeview Hospital Hospital, Bountiful, UT, CCN 460042
• Holy Cross Hospital-Davis Hospital, Layton, UT, CCN 460041
• Holy Cross Hospital-Jordan Valley Hospital, West Jordan, UT, CCN 460051
• Ogden Regional Medical Center Hospital, Ogden, UT, CCN 460005

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rgraham63824@achce.catholichealth.net

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.

• Emergency Physicians Integrated Care, LLC

  • Emergency Medicine Physician
  • Salt Lake City, UT
  • NPI 1578598199
  Medicare reassignment Care Compare group NPD
• New Century Physicians of Nebraska LLC

  • Emergency Medicine Physician
  • Omaha, NE
  • NPI 1013916600
  NPD
• New Century Physicians of Nebraska LLC

  • Emergency Medicine Physician
  • Papillion, NE
  • NPI 1063411833
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Catholic Health Initiatives Colorado

  dba Holy Cross Hospital - Davis

  • General Acute Care Hospital
  • Layton, UT
  • NPI 1346945839
  Care Compare affiliation
• Catholic Health Initiatives Colorado

  dba Holy Cross Hospital - Jordan Valley

  • General Acute Care Hospital
  • West Jordan, UT
  • NPI 1801591391
  Care Compare affiliation
• Columbia Ogden Medical Center, Inc.

  dba Ogden Regional Medical Center

  • General Acute Care Hospital
  • Ogden, UT
  • NPI 1720031636
  Care Compare affiliation
• Hospital Corporation of Utah

  dba Lakeview Hospital

  • General Acute Care Hospital
  • Bountiful, UT
  • NPI 1528010451
  Care Compare affiliation

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

{
    "created_epoch": "1269648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370217600000",
    "number": "1629393160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 HEMPSTEAD STATION DR",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454295164",
            "telephone_number": "800-875-0136",
            "fax_number": "937-619-4150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 MERCY DR",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515033128",
            "telephone_number": "800-875-0136",
            "fax_number": "937-619-4150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "ROBERT",
        "middle_name": "WALLACE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-27",
        "last_updated": "2013-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IA",
            "license": "4438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Hearing Instruments, Inc. (Audology Services & Hearing Aid Center)
• Grace Therapy, PC
• Michael David Grace, BC-HIS
• Stephanie Grade
• Kallee R Graham
• Debrenee D Grajeda, LSW
• Gray Holdings
• Alison Gray, PMHNP
• Stephanie R Gray, ARNP
• Great Plains Holistic Health

• Emergency Medicine Physician in Council Bluffs, IA
• Providers in Council Bluffs, IA by specialty
• Emergency Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.