David Lashawn Graves

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

279 Summit Dr
Waterford, MI 48328-3364

Phone

(678) 379-8559

NPI assigned

Dec 15, 2023

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

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

{
    "created_epoch": "1702598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1922876200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 SENECA ST",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483422350",
            "telephone_number": "678-379-8559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "279 SUMMIT DR",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483283364",
            "telephone_number": "678-379-8559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "DAVID",
        "middle_name": "LASHAWN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-15",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theodore John Gozdzialski, RN
• Graceful Living, Reinventing in-Home Senior Care
• Shawn Graham, LPC
• Aubrey Anne Grant, MA, LPC
• Shelbi Grant, CPT
• Kateri Gray, LLMSW
• Samuel Adam Gray, DC
• Great Lakes Clinical Group, P.C
• Great Lakes Neuromonitoring, PLLC
• Great Lakes Podiatry Associates PLLC

• Peer Specialist in Waterford, MI
• Providers in Waterford, MI by specialty
• Peer Specialist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2023; 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.