Paige E Graham, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

15411-24 Issued in WI

Practice address

8837 W North Ave
Wauwatosa, WI 53226-2725

Phone

(414) 257-0300

Fax

(414) 257-0330

NPI assigned

Mar 1, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Paige E Lincicum Former name

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": "1551398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1730646332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8837 W NORTH AVE",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532262725",
            "telephone_number": "414-257-0300",
            "fax_number": "414-257-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "PAIGE",
        "middle_name": "E",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-01",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "15411-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAIGE",
            "last_name": "LINCICUM",
            "middle_name": "E",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Karen Gotwalt, M.D.
• Bob Matthew Gountis, D.C.
• Charles M Grade, MD
• Donna Ruth Grady, MS
• Justin Michael Graff, PHARM.D.
• Gail E Grahn, PTA
• Janet Carol Grahn, P.T.A.
• Amber Gonzalez Grant, APNP
• Menachem H Graupe, MD
• Terry S Graves, M.D.

• Physical Therapist in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; 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.