Active NPI
Tracy Warwick Graham, MD
- Pediatrics Physician
- Klamath Falls, OR
National Provider Identifier
1831278589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 23546
- Practice address
- 706 Main St Ste 2a
Klamath Falls, OR 97601-6010 - Phone
- (541) 851-7350
- Fax
- (541) 851-7351
- NPI assigned
- Nov 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 23546 | OR | Primary |
Addresses
Primary practice location
706 Main St Ste 2a
Klamath Falls, OR 97601-6010
Mailing address
PO Box 5074
Sioux Falls, SD 57117-5074
Phone (605) 328-6585
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 286410 | Medicaid | OR | |
| XPY197937 | Medicaid | CA |
Other names 1
- Tracy Michelle Warwick
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23546 | OR | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Graham Pediatric Clinic, LLC | Pediatrics | Current | Accepting new patients |
Locations
706 Main St
Ste 2A
Klamath Falls, OR 97601
Phone (541) 591-0877
Interoperability endpoints
- tracy.graham.1@26673.direct.athenahealth.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatrics Physician
- Klamath Falls, OR
- NPI 1174250104
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661385600000",
"number": "1831278589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5074",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571175074",
"telephone_number": "605-328-6585",
"fax_number": "605-328-6512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "706 MAIN ST STE 2A",
"city": "KLAMATH FALLS",
"state": "OR",
"postal_code": "976016010",
"telephone_number": "541-851-7350",
"fax_number": "541-851-7351"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "TRACY",
"middle_name": "WARWICK",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-03",
"last_updated": "2022-08-25",
"certification_date": "2022-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OR",
"license": "23546",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "286410",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "XPY197937",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "TRACY",
"last_name": "WARWICK",
"middle_name": "MICHELLE",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Klamath Falls, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.