Larry G Graham, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

9225 Issued in TN

Practice address

5301 Virginia Way Ste 300
Brentwood, TN 37027-7542

Phone

(615) 221-4474

Fax

(615) 234-3774

NPI assigned

Sep 25, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Associated Pathologists LLC

  • Clinical Medical Laboratory
  • Nashville, TN
  • NPI 1124075635
  NPD (past)
• Pathgroup Labs, LLC

  • Clinical Medical Laboratory
  • Nashville, TN
  • NPI 1235186800
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1871694828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 VIRGINIA WAY STE 300",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277542",
            "telephone_number": "615-221-4474",
            "fax_number": "615-234-3774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 VIRGINIA WAY STE 300",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370277542",
            "telephone_number": "615-221-4474",
            "fax_number": "615-234-3774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "LARRY",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TN",
            "license": "9225",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "KY",
            "license": "24891",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89063F6",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3040511",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64777063",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TLC TENNCARE",
            "identifier": "000005006002",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON TENNCARE",
            "identifier": "119586",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "3025074",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "231705",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric Gott, LPC (TEMP)
• Therese Elizabeth Grable, LPC-MHSP
• Grace Home Care, LLC
• Fallon Graham, MMFT
• Kenton Clay Graham, LPC
• Meg Carpenter Graham
• Suzanne Earnest Graham, LPTA
• Abigail Corrine Grandstaff, MA, BCBA, LBA
• Kara Patricia Granger
• Sarah Grangien

• Anatomic Pathology & Clinical Pathology Physician in Brentwood, TN
• Providers in Brentwood, TN by specialty
• Anatomic Pathology & Clinical Pathology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.