Kathleen Joan Graham, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

02760 Issued in IA

Practice address

6001 Westown Pkwy
West Des Moines, IA 50266-7702

Phone

(515) 224-1414

Fax

(515) 224-5140

NPI assigned

Jul 15, 2011

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

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": "1310688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1811285547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6001 WESTOWN PKWY",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502667719",
            "telephone_number": "515-224-1414",
            "fax_number": "515-224-5140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6001 WESTOWN PKWY",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502667702",
            "telephone_number": "515-224-1414",
            "fax_number": "515-224-5140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 NE 36th St",
            "address_purpose": "LOCATION",
            "city": "Ankeny",
            "state": "IA",
            "postal_code": "500216728",
            "country_code": "US",
            "telephone_number": "515-224-1414",
            "fax_number": "515-224-5140",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1301 Pennsylvania Ave Ste 213",
            "address_purpose": "LOCATION",
            "city": "Des Moines",
            "state": "IA",
            "postal_code": "503162365",
            "country_code": "US",
            "telephone_number": "515-224-1414",
            "fax_number": "515-224-5140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "KATHLEEN",
        "middle_name": "JOAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-15",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "02760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811285547",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in West Des Moines, IA
• Providers in West Des Moines, IA by specialty
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; 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.