William S Graham Jr., MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

114654 Issued in MO

Practice address

600 W College St Ste 120
Springfield, MO 65806-1201

Phone

(417) 831-0022

Fax

(417) 831-0451

NPI assigned

Feb 7, 2007

Last updated

Oct 17, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Sep 17, 2013 through Sep 17, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advocates for a Healthy Community, Inc

  dba Jordan Valley Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Springfield, MO
  • NPI 1558303057
  NPD (past)
• Allied Physicians Group LLC

  dba Breakthrough Pain Relief Clinic

  • Specialist
  • Springfield, MO
  • NPI 1295937423
  NPD (past)
• Pain and Performance Relief LLC

  • Physical Medicine & Rehabilitation Physician
  • Saint Louis, MO
  • NPI 1346597457
  NPD (past)

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350432000000",
    "number": "1962542316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W COLLEGE ST STE 120",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658061201",
            "telephone_number": "417-831-0022",
            "fax_number": "417-831-0451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W COLLEGE ST STE 120",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658061201",
            "telephone_number": "417-831-0022",
            "fax_number": "417-831-0451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "WILLIAM",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2012-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "114654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203756101",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO BLUE SHIELD",
            "identifier": "116495",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARK BLUE SHIELD",
            "identifier": "83834",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alison Gragson
• Douglas A Gragson
• Cynthia R Graham, LPC
• George G Graham Jr., DDS
• Marcia K Graham, MD
• Michelle Granados, RBT
• Grand Dental Studio LLC
• Rebecca Granden
• Diego Hernan Granja, M.D. MSC
• Connor Jeffery Grant, DO

• Family Medicine Physician in Springfield, MO
• Providers in Springfield, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.