Active NPI
Graham Edson
- Physical Therapist
- Shelbyville, TN
National Provider Identifier
1699257550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 105 Northside Park Dr
Shelbyville, TN 37160-2062 - Phone
- (931) 735-6451
- NPI assigned
- Sep 6, 2018
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
105 Northside Park Dr
Shelbyville, TN 37160-2062
Mailing address
PO Box 681478
Franklin, TN 37068-1478
Phone (615) 591-6590
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0446631 | Medicaid | TN |
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": "1536192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536192000000",
"number": "1699257550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 681478",
"city": "FRANKLIN",
"state": "TN",
"postal_code": "370681478",
"telephone_number": "615-591-6590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 NORTHSIDE PARK DR",
"city": "SHELBYVILLE",
"state": "TN",
"postal_code": "371602062",
"telephone_number": "931-735-6451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDSON",
"first_name": "GRAHAM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-06",
"last_updated": "2018-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0446631",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shelbyville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.