Active NPI
Donald D Graber, M.D.
- Psychiatry Physician
- Cottonwood, AZ
National Provider Identifier
1669408548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 01024485A
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000375988 | Other | IN | ANTHEM |
| 100112580 | Medicaid | IN | |
| P00310132 | Other | IN | ANTHEM 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.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01024485A | IN | MD | Psychiatry 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.