Ryan Farrell Graham

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT2652 Issued in SC

Practice address

A3669 Butner Rd
Fort Bragg, NC 28310-0001

Phone

(910) 850-1619

NPI assigned

Apr 8, 2022

Sex

Male

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

State licenses

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

{
    "created_epoch": "1649376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1760124952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 VIC KEITH RD",
            "city": "SANFORD",
            "state": "NC",
            "postal_code": "273321152",
            "telephone_number": "910-850-1619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "A3669 BUTNER RD",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283100001",
            "telephone_number": "910-850-1619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "RYAN",
        "middle_name": "FARRELL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-08",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "SC",
            "license": "AT2652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Lee Gottardi, MSCCC/SLP
• Natasha Gouey, DO
• Kristy Leigh Gould, DNP, APRN, PMHNP-BC
• Gabriella Marie Gracia, PA-C
• Mindy Leigh Grady, CRNA
• William James Graham IV, DMD
• Donald Max Grambusch, PA-C
• Joseph T Granger, PT
• Kari Anne Grant, MSW, LCSW
• Samuel L Grasso, D.O.

• All providers in Fort Bragg, NC
• Athletic Trainer in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.

Verify at the official NPI Registry.