Nathan Graves, D.P.M.
Individual provider Active NPI Foot & Ankle Surgery Podiatrist · Kokomo, IN
NPI 1942567433 · NPPES record last updated Apr 17, 2024
Key facts
- NPI
- 1942567433
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Foot & Ankle Surgery Podiatrist 213ES0103X
- License
- 07001200A (IN)
- Practice address
- 209 Corwin LN
Kokomo, IN 46902-6612 - Phone
- (765) 456-5630
- NPI assigned
- Apr 20, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Podiatry
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St Vincent Medical Group Inc
Practice addresses (Care Compare)
1907 W Sycamore St
Suite 200
Kokomo, IN 46901-5148
Phone (765) 236-8170
Hospital & facility affiliations
- Ascension St Vincent Mercy
- Ascension St Vincent Kokomo
- Ascension St Vincent Fishers
- Community Hospital of Anderson and Madison County
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 1-10 |
| Melanoma (skin cancer) excision | 1-10 |
| Removal of tissue | 64 |
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 26 |
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150518001116 | IN | Practitioner - Podiatry | 8426378365 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 07001200A | IN | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Vincent Medical Group Inc | Past | Accepting new patients |
Interoperability endpoints
- ngraves@ipgi-in.direct.office.nextgen.com
- nathan.graves.1@7598.direct.athenahealth.com
- ngraves186633@ecommunitydirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 07001200A | IN | |
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 07001200A | IN | Yes |
Addresses
Primary practice location
209 Corwin LN
Kokomo, IN 46902-6612
Mailing address
209 Corwin LN
Kokomo, IN 46902-6612
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | nathan.graves.1@7598.direct.athenahealth.com | St. Vincent Medical Group, Inc. |
NPI Registry JSON
{
"created_epoch": "1334880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713312000000",
"number": "1942567433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 CORWIN LN",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469026612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 CORWIN LN",
"city": "KOKOMO",
"state": "IN",
"postal_code": "469026612",
"telephone_number": "765-456-5630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAVES",
"first_name": "NATHAN",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-04-20",
"last_updated": "2024-04-17",
"certification_date": "2024-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "IN",
"license": "07001200A",
"primary": false
},
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "IN",
"license": "07001200A",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "nathan.graves.1@7598.direct.athenahealth.com",
"affiliation": "Y",
"affiliationName": "St. Vincent Medical Group, Inc.",
"address_1": "209 Corwin Ln",
"city": "Kokomo",
"state": "IN",
"country_code": "US",
"postal_code": "469026612",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Kokomo, IN
- Annelise Graham
- Taerynn Graham
- Tina Marie Granfield
- Jessalyn Suzanne Grant
- Cherah Renee Graves
- Joshua Gray
- Bethany Green
- Emily Greer
- Gerald Kevin Greer
- Nicole Gregory
All providers in Kokomo, IN · Foot & Ankle Surgery Podiatrist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.