Dexter Graham

Primary specialty

Home Modifications ContractorTaxonomy code 171WH0202X

License

G116035 Issued in SC

Practice address

513 2ND Ave
Kingstree, SC 29556-2913

Phone

(843) 401-8423

Fax

(843) 354-7985

NPI assigned

Feb 8, 2016

Last updated

Feb 8, 2016By 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.

• The D Graham Group LLC

  • Home Modifications Contractor
  • Kingstree, SC
  • NPI 1891153193
  NPD (past) Authorized official

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

{
    "created_epoch": "1454889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454889600000",
    "number": "1851759690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 2ND AVE",
            "city": "KINGSTREE",
            "state": "SC",
            "postal_code": "295562913",
            "telephone_number": "843-401-8423",
            "fax_number": "843-354-7985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 2ND AVE",
            "city": "KINGSTREE",
            "state": "SC",
            "postal_code": "295562913",
            "telephone_number": "843-401-8423",
            "fax_number": "843-354-7985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "DEXTER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-08",
        "last_updated": "2016-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "",
            "desc": "Contractor, Home Modifications",
            "state": "SC",
            "license": "G116035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Good Samaritan Adult Day Care
• Good Samaritan Home Care Services, LLC
• Good Samaritan Residential Care
• Domonique Jones Goode
• Graceful Companion Home Care LLC
• James A. Graham Jr.
• Meridith Tara Graham, LISW CP
• Sheretta Graham
• Tashanda Graham
• Letitia Chovine Grayson

• Home Modifications Contractor in Kingstree, SC
• Providers in Kingstree, SC by specialty
• Home Modifications Contractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2016; 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.