Active NPI
Kyle G Graham, DPT
- Physical Therapist
- Corinth, MS
National Provider Identifier
1629648951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT7132
- Practice address
- 2503 Virginia LN
Corinth, MS 38834-6530 - Phone
- (662) 977-7180
- Fax
- (662) 997-7182
- NPI assigned
- Jun 29, 2021
- 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 | PT7132 | MS | Primary |
Addresses
Primary practice location
2503 Virginia LN
Corinth, MS 38834-6530
Mailing address
1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 206-4158
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 |
|---|---|---|---|
| PT7132 | MS | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Drayer Physical Therapy Mississippi LLC | 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 and National Provider Directory roles.
-
- Physical Therapist
- Crystal Springs, MS
- NPI 1801333521
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624924800000",
"number": "1629648951",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 CORPORATE DR STE 400",
"city": "HOOVER",
"state": "AL",
"postal_code": "352425424",
"telephone_number": "423-206-4158",
"fax_number": "717-773-4654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2503 VIRGINIA LN",
"city": "CORINTH",
"state": "MS",
"postal_code": "388346530",
"telephone_number": "662-977-7180",
"fax_number": "662-997-7182"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "KYLE",
"middle_name": "G",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-29",
"last_updated": "2021-06-29",
"certification_date": "2021-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MS",
"license": "PT7132",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corinth, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.