Jacob D Graham, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2018028447 Issued in MO

Practice address

1300 Veterans Blvd
Festus, MO 63028-2394

Phone

(636) 931-2100

Fax

(636) 931-2300

NPI assigned

Aug 23, 2018

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)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: jacob.graham.p2@direct.athleticoltd.nextgenshare.com

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

{
    "created_epoch": "1534982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1831670249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 OAKMONT LN STE 600C",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595548",
            "telephone_number": "630-575-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 VETERANS BLVD",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630282394",
            "telephone_number": "636-931-2100",
            "fax_number": "636-931-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "JACOB",
        "middle_name": "D",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-23",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2018028447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Lynn Gooch, RPH
• Victoria L Goodman, LPN
• James Dean Gould, M.D.
• Christina Lynn Gower, MAC, LPC
• Sydney Grab
• Taylor Gravatt, LPC
• Amber Sue Gray, LMSW
• Cara Gray
• Christopher Charles Gray, D.O.
• Courtney Rose Gray, AGPCNP-BC

• Physical Therapist in Festus, MO
• Providers in Festus, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 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.