Individual provider Active NPI

Donald D Graber, M.D.

  • Psychiatry Physician
  • Cottonwood, AZ
National Provider Identifier
1669408548
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
01024485A Issued in IN
Practice address
8 E Cottonwood St BLDG C
Verde Valley Guidance Clinic, Inc.
Cottonwood, AZ 86326-6237
Phone
(928) 634-2236
Fax
(928) 634-8960
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 01024485A IN Primary

Addresses

Primary practice location

8 E Cottonwood St BLDG C
Verde Valley Guidance Clinic, Inc.
Cottonwood, AZ 86326-6237

Mailing address

8 E Cottonwood St BLDG a
Verde Valley Guidance Clinic, Inc.
Cottonwood, AZ 86326-6237
Phone (928) 634-2236

Other identifiers 3

IdentifierTypeStateIssuer
000000375988OtherINANTHEM
100112580MedicaidIN
P00310132OtherINANTHEM PIN

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01024485AINMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354060800000",
    "number": "1669408548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 E COTTONWOOD ST BLDG A",
            "address_2": "VERDE VALLEY GUIDANCE CLINIC, INC.",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863266237",
            "telephone_number": "928-634-2236",
            "fax_number": "928-634-8960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 E COTTONWOOD ST BLDG C",
            "address_2": "VERDE VALLEY GUIDANCE CLINIC, INC.",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863266237",
            "telephone_number": "928-634-2236",
            "fax_number": "928-634-8960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRABER",
        "first_name": "DONALD",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2012-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01024485A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000375988",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100112580",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "P00310132",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottonwood, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.