Active NPI
Theoni S Graham, M.S.
- Audiologist
- Newport News, VA
National Provider Identifier
1992730691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 2201000216
- Practice address
- 808 Triton CT Ste 100
Newport News, VA 23606-4520 - Phone
- (757) 874-4665
- Fax
- (757) 874-1286
- NPI assigned
- Jul 11, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 2201000216 | VA | Primary |
Addresses
Primary practice location
808 Triton CT Ste 100
Newport News, VA 23606-4520
Mailing address
808 Triton CT Ste 100
Newport News, VA 23606-4520
Phone (757) 874-4665
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51143 | Other | VA | SENTARA/OPTIMA PROVIDER |
| 540972387 | Other | VA | AETNA/TRICARE PROVIDER |
| 386056 | Other | VA | ANTHEM PROVIDER NUMBER |
| 0723576002 | Other | VA | CIGNA PROVIDER NUMBER |
| 148932100 | Other | VA | DEPT OF LABOR PROVIDER |
| 640004704 | Other | VA | MEDICARE RAILROAD PROVIDE |
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2201000216 | VA | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546905600000",
"number": "1992730691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "808 TRITON CT STE 100",
"city": "NEWPORT NEWS",
"state": "VA",
"postal_code": "236064520",
"telephone_number": "757-874-4665",
"fax_number": "757-874-1286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "808 TRITON CT STE 100",
"city": "NEWPORT NEWS",
"state": "VA",
"postal_code": "236064520",
"telephone_number": "757-874-4665",
"fax_number": "757-874-1286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "THEONI",
"middle_name": "S",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-11",
"last_updated": "2019-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "VA",
"license": "2201000216",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SENTARA/OPTIMA PROVIDER",
"identifier": "51143",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA/TRICARE PROVIDER",
"identifier": "540972387",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM PROVIDER NUMBER",
"identifier": "386056",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA PROVIDER NUMBER",
"identifier": "0723576002",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF LABOR PROVIDER",
"identifier": "148932100",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD PROVIDE",
"identifier": "640004704",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newport News, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.