Terrence M Graham, DPM,FACFAS

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

016003032 Issued in IL

Practice address

2 Memorial Dr Ste 305
Decatur, IL 62526-3999

Phone

(217) 876-4830

Fax

(217) 876-8385

NPI assigned

Nov 16, 2005

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519776000000",
    "number": "1972585990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 W KENWOOD AVE",
            "address_2": "SUITE 150",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264368",
            "telephone_number": "217-875-3668",
            "fax_number": "217-875-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MEMORIAL DR STE 305",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263999",
            "telephone_number": "217-876-4830",
            "fax_number": "217-876-8385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "TERRENCE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DPM,FACFAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2018-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IL",
            "license": "016003032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0060215009",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "480008850",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016003032",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gowdar & Gowdar MD SC
• Kusuma Gowdar, MD
• Prasanna Gowdar, MD
• Natalie K Gower, M.S. CCC-SLP
• Geniel Grabowski, LCSW
• Christopher Hastings Gram, MD
• Emilye Jessica Grant, PHYSICIAN ASSISTANT
• Shaylon Carlene Grant, FNP-BC
• Maria Granzotti, M.D.
• Ronald James Grason, M.D.

• Foot & Ankle Surgery Podiatrist in Decatur, IL
• Providers in Decatur, IL by specialty
• Foot & Ankle Surgery Podiatrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2018; 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.