Individual provider Active NPI

Luann Ely Graves

  • Medical Technologist
  • White River Junction, VT
National Provider Identifier
1669665618
Registry record updated Aug 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical TechnologistTaxonomy code 246QM0706X
Practice address
215 N Main St
Building 1, Room 162
White River Junction, VT 05009-0001
Phone
(802) 295-9363
Fax
(802) 296-6476
NPI assigned
Aug 23, 2007
Last updated
Aug 23, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Technologist 246QM0706X NU Primary

Addresses

Primary practice location

215 N Main St
Building 1, Room 162
White River Junction, VT 05009-0001

Mailing address

74 Butternut Rd
Norwich, VT 05055-9790
Phone (802) 649-3957

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": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187827200000",
    "number": "1669665618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 BUTTERNUT RD",
            "city": "NORWICH",
            "state": "VT",
            "postal_code": "050559790",
            "telephone_number": "802-649-3957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N MAIN ST",
            "address_2": "BUILDING 1, ROOM 162",
            "city": "WHITE RIVER JUNCTION",
            "state": "VT",
            "postal_code": "050090001",
            "telephone_number": "802-295-9363",
            "fax_number": "802-296-6476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "LUANN",
        "middle_name": "ELY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-23",
        "last_updated": "2007-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246QM0706X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Medical Technologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White River Junction, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2007; 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.