Amanda Nicole Graham, LPTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

7194 Issued in TN

Practice address

875 Larry Neil Way
Kingsport, TN 37660-6368

Phone

(423) 282-9572

NPI assigned

Dec 7, 2020

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1750987707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 SUSANNAH ST",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376011748",
            "telephone_number": "423-282-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 LARRY NEIL WAY",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376606368",
            "telephone_number": "423-282-9572"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "340 Steeles Rd",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376209532",
            "country_code": "US",
            "telephone_number": "423-282-9011",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2410 Susannah St",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376011748",
            "country_code": "US",
            "telephone_number": "423-282-9011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "AMANDA",
        "middle_name": "NICOLE",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-07",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TN",
            "license": "7194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Wesley Gordon, M.D.
• Natasha Benfield Gouge, PHD
• Amber P Gourley, RD
• Grace Care Pharmacy
• Brittany Nicole Graham Dockery, LPN
• Tina Renee Graham, FNP
• Alli Quinn Gray, FNP
• Edward C Gray, M.D
• Graybeal Orthopedic LLC
• Greater Kingsport Family Young Men'S Christian Association, Inc.

• Physical Therapy Assistant in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Physical Therapy Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; 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.