Individual provider Active NPI

Lynda C.S. Graves, M.D.

  • Family Medicine Physician
  • Minersville, PA
National Provider Identifier
1962472258
Registry record updated Jan 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD022224E Issued in PA
Practice address
210 Sunbury St
Minersville, PA 17954-1346
Phone
(570) 544-9123
Fax
(570) 544-9263
NPI assigned
Jan 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD022224E PA Primary

Addresses

Primary practice location

210 Sunbury St
Minersville, PA 17954-1346

Mailing address

210 Sunbury St
Minersville, PA 17954-1346
Phone (570) 544-9123

Other identifiers 1

IdentifierTypeStateIssuer
000731220MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295913600000",
    "number": "1962472258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 SUNBURY ST",
            "city": "MINERSVILLE",
            "state": "PA",
            "postal_code": "179541346",
            "telephone_number": "570-544-9123",
            "fax_number": "570-544-9263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 SUNBURY ST",
            "city": "MINERSVILLE",
            "state": "PA",
            "postal_code": "179541346",
            "telephone_number": "570-544-9123",
            "fax_number": "570-544-9263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "LYNDA",
        "middle_name": "C.S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-26",
        "last_updated": "2011-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD022224E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000731220",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minersville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; 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.