Jason Randall Graham, DO

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4192 Issued in OK

Practice address

4023 NW 10TH St
Oklahoma City, OK 73107-6038

Phone

(405) 632-6688

Fax

(844) 689-9671

NPI assigned

Aug 13, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pediatric Medicine

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Variety Care, Inc.Group PAC ID 1557260007, 101 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/2d405cde-1d8b-4a50-adff-ca7776cd856e/
• Direct secure messaging: jgraham376300@direct.ochin.org

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.

• Variety Care, Inc.

  dba Variety Care, Straka

  • Federally Qualified Health Center (FQHC)
  • Oklahoma City, OK
  • NPI 1780697813
  Medicare reassignment Care Compare group NPD
• Variety Care, Inc

  dba Variety Care Fort Cobb

  • Federally Qualified Health Center (FQHC)
  • Fort Cobb, OK
  • NPI 1275646143
  NPD
• Variety Care, Inc.

  dba Variety Care Mobile Women's Health

  • Federally Qualified Health Center (FQHC)
  • Oklahoma City, OK
  • NPI 1942045455
  NPD
• Cherokee Nation

  • Multi-Specialty Clinic/Center
  • Tahlequah, OK
  • NPI 1093722324
  NPD (past)
• Northeastern State University College of Optometry

  • Optometrist
  • Tahlequah, OK
  • NPI 1437106333
  NPD (past)
• Summit Medical Center

  • General Acute Care Hospital
  • Edmond, OK
  • NPI 1356574560
  NPD (past)

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1841202298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 N GRAND BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731071818",
            "telephone_number": "405-632-6688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4023 NW 10TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731076038",
            "telephone_number": "405-632-6688",
            "fax_number": "844-689-9671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "JASON",
        "middle_name": "RANDALL",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "4192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1204192",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Denisha Graham, BS, IBCLC
• Drew Graham, PA-C
• Heather Graham, APRN-CNS
• Hilary I Graham, AUD
• James Franklin Graham
• Jimmy Lee Graham
• Kendal Graham
• Leann Graham, PHARM.D.
• Louanna Kristi Graham, LADC/MH-SUPERVISOR
• Madeline Jane Graham, MD

• Pediatrics Physician in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Pediatrics Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.