Active NPI
Patrick Graham, LMSW
- Social Worker
- Paragould, AR
National Provider Identifier
1700169539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 1613-M
- Practice address
- 100 N Rockingchair Rd Ste 1-3
Paragould, AR 72450-2413 - Phone
- (870) 335-9617
- Fax
- (870) 335-9618
- NPI assigned
- Sep 28, 2011
- Last updated
- Sep 28, 2011
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 1613-M | AR | Primary |
Addresses
Primary practice location
100 N Rockingchair Rd Ste 1-3
Paragould, AR 72450-2413
Mailing address
100 N Rockingchair Rd Ste 1-3
Paragould, AR 72450-2413
Phone (870) 335-9617
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1613-M | AR | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317168000000",
"number": "1700169539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 N ROCKINGCHAIR RD STE 1-3",
"city": "PARAGOULD",
"state": "AR",
"postal_code": "724502413",
"telephone_number": "870-335-9617",
"fax_number": "870-335-9618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 N ROCKINGCHAIR RD STE 1-3",
"city": "PARAGOULD",
"state": "AR",
"postal_code": "724502413",
"telephone_number": "870-335-9617",
"fax_number": "870-335-9618"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "PATRICK",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-28",
"last_updated": "2011-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "AR",
"license": "1613-M",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Paragould, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.