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

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

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 (728 clinicians)

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 Hospital · Elwood, IN · CCN 151308
  • Ascension St Vincent Kokomo Hospital · Kokomo, IN · CCN 150010
  • Ascension St Vincent Fishers Hospital · Fishers, IN · CCN 150181
  • Community Hospital of Anderson and Madison County Hospital · Anderson, IN · CCN 150113

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue64
Removal of skin lesions1-10
Removal of nail tissue26
Removal or shaving of skin growth1-10

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 IDStateProvider typePAC IDDetails
I20150518001116 IN Practitioner - Podiatry 8426378365 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
07001200AINMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Medical Group Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ngraves@ipgi-in.direct.office.nextgen.com
  • Direct secure messaging: nathan.graves.1@7598.direct.athenahealth.com
  • Direct secure messaging: ngraves186633@ecommunitydirect.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
Direct Messaging Address nathan.graves.1@7598.direct.athenahealth.com St. Vincent Medical Group, Inc.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 17, 2024.

{
    "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

All providers in Kokomo, IN · Foot & Ankle Surgery Podiatrist in Indiana

Sources for this page

Verify at the official NPI Registry.