Ted R Graves

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LDC0739 Issued in TN

Practice address

942 Andrew Jackson Dr
Waynesboro, TN 38485-2360

Phone

(931) 722-3272

NPI assigned

Jun 28, 2018

Last updated

Jun 28, 2018By the provider in NPPES

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wayne Halfway House Inc.

  • Psychiatric Residential Treatment Facility
  • Waynesboro, TN
  • NPI 1174818702
  NPD (past)

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

{
    "created_epoch": "1530144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1821583071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 NORTHVIEW RD",
            "city": "HOHENWALD",
            "state": "TN",
            "postal_code": "384623402",
            "telephone_number": "931-626-2052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "942 ANDREW JACKSON DR",
            "city": "WAYNESBORO",
            "state": "TN",
            "postal_code": "384852360",
            "telephone_number": "931-722-3272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "TED",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-28",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TN",
            "license": "LDC0739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Faith & Family Care Clinic PLLC
• Family Health Group Inc
• Meredith Leigh Fleming
• Gena Garrard, RN
• Jay Dee Glass
• William Mitchell Greene
• Bess A. Greevy, APRN, BC, CNM
• Susan Elaine Groft
• Valerie Ann Hall-Glass, APN
• Hallmedical Clinic LLC

• Addiction (Substance Use Disorder) Counselor in Waynesboro, TN
• Providers in Waynesboro, TN by specialty
• Addiction (Substance Use Disorder) Counselor in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; 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.