Richard J Graham, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

E0016 Issued in AR

Practice address

9601 Lile Dr
S-940
Little Rock, AR 72205-6321

Phone

(501) 219-9198

Fax

(501) 219-9209

NPI assigned

Jun 18, 2007

Reactivated

Aug 31, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188518400000",
    "number": "1710182035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9601 LILE DR",
            "address_2": "S-940",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056321",
            "telephone_number": "501-219-9198",
            "fax_number": "501-219-9209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 LILE DR",
            "address_2": "S-940",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056321",
            "telephone_number": "501-219-9198",
            "fax_number": "501-219-9209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "RICHARD",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-18",
        "last_updated": "2007-08-31",
        "deactivation_date": "2007-08-10",
        "reactivation_date": "2007-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "AR",
            "license": "E0016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katy Elizabeth Graham, M.S.,CCC-SLP
• Leeanna Graham
• Lori Kristine Graham, LMSW
• Rachel Marie Graham, MD, MPH
• Rebecca Graham, LPC, LMFT
• Rusty Lynn Graham
• Shannon Renee Graham, APRN
• Shena Graham
• Stephanie Brooke Graham, MHPP
• Travis Graham, PHARMD

• All providers in Little Rock, AR
• Physical Medicine & Rehabilitation Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.