Active NPI
Lisa Michelle Graham
- Attendant Care Provider
- Shelbyville, IL
National Provider Identifier
1720736788
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Attendant Care Provider
- Practice address
- 815 N Long St
Shelbyville, IL 62565-1172 - Phone
- (217) 820-9496
- NPI assigned
- Mar 17, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Attendant Care Provider | 3747A0650X | IL | Primary |
Addresses
Primary practice location
815 N Long St
Shelbyville, IL 62565-1172
Mailing address
1528 E 950 North Rd
Lakewood, IL 62438-4029
Phone (217) 690-8288
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": "1647475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649203200000",
"number": "1720736788",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1528 E 950 NORTH RD",
"city": "LAKEWOOD",
"state": "IL",
"postal_code": "624384029",
"telephone_number": "217-690-8288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "815 N LONG ST",
"city": "SHELBYVILLE",
"state": "IL",
"postal_code": "625651172",
"telephone_number": "217-820-9496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "LISA",
"middle_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-17",
"last_updated": "2022-04-06",
"certification_date": "2022-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "3747A0650X",
"taxonomy_group": "",
"desc": "Technician, Attendant Care Provider",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shelbyville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.