Individual provider Active NPI

Emily R Graham, RD, LD, CDE

  • Registered Dietitian
  • Des Moines, IA
National Provider Identifier
1902130933
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
001806 Issued in IA
Practice address
411 Laurel St Ste 3262
Des Moines, IA 50314-3027
Phone
(515) 643-5100
Fax
(515) 643-5150
NPI assigned
Sep 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 001806 IA Primary

Addresses

Primary practice location

411 Laurel St Ste 3262
Des Moines, IA 50314-3027

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 643-5100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091023000216 IA Practitioner - Registered Dietitian Or Nutrition Professional 9436296415 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinics, Inc Dietitian, Registered CurrentSince Feb 1, 2014 Accepting new patients
Mercy Clinics, Inc. CurrentSince Feb 1, 2014 Accepting new patients
Mercy Clinics, Inc. Current Accepting new patients

Locations

800 E 1st St
Ste 1700
Ankeny, IA 50021
Phone (515) 643-8100

1601 NW 114th St
Ste 342
Clive, IA 50325
Phone (515) 222-7600

405 SW 5th St
Ste E
Des Moines, IA 50309
Phone (515) 358-7259

330 Laurel St
Ste 1200
Des Moines, IA 50314
Phone (515) 643-5454

411 Laurel St
Ste 3100
Des Moines, IA 50314
Phone (515) 235-5000

6601 SW 9th St
Ste 2
Des Moines, IA 50315

411 Laurel St
Ste 3320
Des Moines, IA 50314

411 Laurel St
Ste 3262
Des Moines, IA 50314
Phone (515) 643-5100

5900 E University Ave
Ste 100
Pleasant Hill, IA 50327
Phone (515) 643-2400

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1253664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1902130933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503051475",
            "telephone_number": "515-643-5100",
            "fax_number": "515-643-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 LAUREL ST STE 3262",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503143027",
            "telephone_number": "515-643-5100",
            "fax_number": "515-643-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "EMILY",
        "middle_name": "R",
        "credential": "RD, LD, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-23",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "IA",
            "license": "001806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.