Richard Graebe II

Primary specialty

OptometristTaxonomy code 152W00000X

License

1044-DT Issued in KY

Practice address

105 Crossfield Dr
Versailles, KY 40383-1444

Phone

(859) 879-3665

Fax

(859) 879-3662

NPI assigned

Mar 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336003200000",
    "number": "1710956131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 CROSSFIELD DR",
            "city": "VERSAILLES",
            "state": "KY",
            "postal_code": "403831444",
            "telephone_number": "859-879-3665",
            "fax_number": "859-879-3662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 CROSSFIELD DR",
            "city": "VERSAILLES",
            "state": "KY",
            "postal_code": "403831444",
            "telephone_number": "859-879-3665",
            "fax_number": "859-879-3662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAEBE",
        "first_name": "RICHARD",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2012-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1044-DT",
            "primary": true
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "",
            "desc": "Optometrist, Vision Therapy",
            "state": "KY",
            "license": "1044-DT",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "77010445",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shaina Goode
• Conny Dale Goodin, MD
• Callie Ann Gormley
• Krystal Grabeel-Hamlin
• Lisa Todd Graddy, LCSW, MS
• Scott A. Gralheer, D.C.
• Keela Grant, BSN, RN, RNC-OB
• Melissa Ann Green, BSN, RN
• Jammie Gribble, PT
• Kristi Jo Grider, FNP-C

• Optometrist in Versailles, KY
• Providers in Versailles, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.

Verify at the official NPI Registry.