Blake D Graham, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

DR.0054808 Issued in CO

Practice address

1650 Cochrane Cir
Pediatrics
Ft Carson, CO 80913-4603

Phone

(719) 526-7653

NPI assigned

Mar 31, 2006

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 CO

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: blake.graham@mvmg.eclinicaldirectplus.com
• Direct secure messaging: bgraham573129@direct.centracare.com

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.

• Alpine Medical Group Colorado PLLC

  • Family Medicine Physician
  • Denver, CO
  • NPI 1104501873

  Pediatrics

  Medicare reassignment NPD
• Valley View Hospital Association

  • Neurological Surgery Physician
  • Aspen, CO
  • NPI 1376134841
  Medicare reassignment
• Valley View Hospital Association

  • Cardiovascular Disease Physician
  • Glenwood Springs, CO
  • NPI 1437271285
  NPD
• Valley View Hospital Association

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Carbondale, CO
  • NPI 1457235202
  NPD
• Valley View Hospital Association

  • Surgery Physician
  • Glenwood SPGS, CO
  • NPI 1518353218
  NPD

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1639130180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809134613",
            "telephone_number": "719-526-9085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR",
            "address_2": "PEDIATRICS",
            "city": "FT CARSON",
            "state": "CO",
            "postal_code": "809134603",
            "telephone_number": "719-526-7653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "BLAKE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CO",
            "license": "DR.0054808",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "274742-1205",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Goodman, DPM
• Erin P Goodman, FNP
• Ann Marie Gorgas, PSY.D.
• Daniel Todd Gorrill, LMFT, LPC
• Jordan Goslin, LCSW
• Ryan D Graham, PH.D.
• Eric H Grant, DO
• Lisa Marie Gray, DNP
• Sandra Green, LPN
• Sierra Green, DDS

• Pediatrics Physician in Ft Carson, CO
• Providers in Ft Carson, CO by specialty
• Pediatrics Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.