Active NPI
Ketura Blondelle Lauture Graham
- Behavior Analyst
- East Lansing, MI
National Provider Identifier
1669102794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 620 Farm LN RM 213
East Lansing, MI 48824-1600 - Phone
- (857) 236-3114
- NPI assigned
- Jun 13, 2022
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
620 Farm LN RM 213
East Lansing, MI 48824-1600
Mailing address
620 Farm LN RM 213
East Lansing, MI 48824-1600
Phone (857) 236-3114
Other practice location 1
620 Farm Ln Rm 213
East Lansing, MI 48824-1600
Phone (857) 236-3114
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://earlylearning.msu.edu | Other |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1655078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1655251200000",
"number": "1669102794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 FARM LN RM 213",
"city": "EAST LANSING",
"state": "MI",
"postal_code": "488241600",
"telephone_number": "857-236-3114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 FARM LN RM 213",
"city": "EAST LANSING",
"state": "MI",
"postal_code": "488241600",
"telephone_number": "857-236-3114"
}
],
"practiceLocations": [
{
"address_1": "620 Farm Ln Rm 213",
"address_purpose": "LOCATION",
"city": "East Lansing",
"state": "MI",
"postal_code": "488241600",
"country_code": "US",
"telephone_number": "857-236-3114",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GRAHAM",
"first_name": "KETURA",
"middle_name": "BLONDELLE LAUTURE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-06-13",
"last_updated": "2022-06-15",
"certification_date": "2022-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://earlylearning.msu.edu",
"affiliation": "N",
"endpointDescription": "ELI Site",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "Contact Through Site",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Operational Director",
"address_1": "620 Farm Ln Rm 213",
"city": "East Lansing",
"state": "MI",
"country_code": "US",
"postal_code": "488241600",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in East Lansing, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.