GARY LEE GRAHAM (NPI# 1992129704) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992129704 |
| Entity Type | Individual |
| Full Name | GARY LEE GRAHAM |
| Credential | NP |
| Practice Address |
14799 Dix Toledo Rd # 200 Southgate MI 48195 |
| Mailing Address |
5039 Villa Linde Pkwy Ste 30 Flint MI 48532-3450 |
| Practice Telephone | 7343248326 |
| Mailing Telephone | 7343248326 |
| Enumeration Date | 2014-02-13 |
| Last Update Date | 2020-06-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
4704197715 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 111 E 1st St, Monroe, MI 481612265 | 7343447432 | |
| 17321 Telegraph Rd, Detroit, MI 482193132 | 3135312500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336532175 | Gary Graham Jr. | Registered Nurse | 13045 228th St, Laurelton, NY 11413-1742 | 2015-03-17 |
| 1700274586 | Gary Lynn Graham Jr. | Physical Therapy Assistant | 760 Canyon Oaks Dr, Apt C, Oakland, CA 94605-3869 | 2015-01-02 |
| 1992848592 | Gary A. Graham | Chiropractor | 151 Route 27, Raymond, NH 03077-1217 | 2007-02-14 |
| 1477567170 | Gary R Graham | Family Medicine | 4605 Belford Cir, Broomfield, CO 80023-8110 | 2006-07-28 |
| 1710970264 | Gary C Graham | Ophthalmology | 517 W 23rd St, Merced, CA 95340-3724 | 2005-08-30 |
| 1538160692 | Gary Robert Graham | Radiology | 2776 Enterprise Rd # 100, Orange City, FL 32763-8316 | 2005-08-10 |
| 1356508287 | Gary Peter Graham | Surgery | 1305 W Jefferson St Ste 120, Waxahachie, TX 75165-2251 | 2008-05-19 |
| 1518057421 | Gary Clayton Graham | Social Worker | 2603 W Wackerly St, Midland, MI 48640 | 2006-10-13 |
| 1811910359 | Gary F Graham | Family Medicine | 210 W 300 N, Roosevelt, UT 84066-2336 | 2006-07-25 |
| 1801871702 | Gary Michael Graham | Nurse Anesthetist, Certified Registered | 1 Medical Center Blvd, Winston Salem, NC 27157-0001 | 2005-12-13 |
| Street Address |
14799 DIX TOLEDO RD # 200 |
| City | SOUTHGATE |
| State | MI |
| Zip Code | 48195 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780206656 | Destiny D Harris | Social Worker | 14799, Southgate, MI 48195 | 2020-05-13 |
| 1285102368 | Svs Vision Inc | Eyewear Supplier (Equipment, not the service) | 16256 Fort St, Southgate, MI 48195 | 2018-11-07 |
| 1003382979 | Saran Charisse Watts | Case Manager/Care Coordinator | 31101 Allen Rd, Building 5, Southgate, MI 48195 | 2018-10-18 |
| 1255824025 | Kiesta Janell Lindsey | Social Worker | 13101 Allen Rd Bldg 4-f, Southgate, MI 48195 | 2018-06-07 |
| 1417473224 | Suzette Michele Watson | Nurse Practitioner | 14319 Dix-toledo, Southgate, MI 48195 | 2017-08-15 |
| 1275069486 | Liza Du Plessis | Student in an Organized Health Care Education/Training Program | 13111 Allen Road, Southgate, MI 48195 | 2017-05-08 |
| 1497290456 | Beaumont Health | Clinic/Center | 15777 Northline, Southgate, MI 48195 | 2016-12-30 |
| 1184172876 | Felicia Wilson | Licensed Practical Nurse | 15771 Wildemere, Southgate, MI 48195 | 2016-09-12 |
| 1225487978 | Stacey Petrick-strickland | Technician, Other | 12189 Agnes, Southgate, MI 48195 | 2016-06-03 |
| 1205298486 | Ashley Francis | Hearing Instrument Specialist | 18800 Eureka Rd., Southgate, MICHIGAN 48195 | 2016-03-25 |
| Find all providers in zip 48195 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215554803 | Sheila Renee Hatton | Nurse Practitioner | 14799 Dix Toledo Rd, Southgate, MI 48195-2507 | 2020-06-29 |
| 1336530252 | Michael Salinas | Nurse Practitioner | 14799 Dix Toledo Rd, Southgate, MI 48195-2507 | 2015-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720692494 | Memphis Chardell Sandoval | Nurse Practitioner | 131 S. Seaway Dr., Muskegon, MI 49441 | 2020-09-01 |
| 1588282784 | Mary Tackbary | Nurse Practitioner | 3932 W Briar Hill Dr, Maple City, MI 49664-9521 | 2020-07-14 |
| 1962032227 | Westlake Consultation Center | Nurse Practitioner | 4870 W Clark Rd Ste 100, Ypsilanti, MI 48197-1104 | 2020-01-24 |
| 1689211823 | Wanda Edwards | Nurse Practitioner | 29000 Inkster Rd Ste 115, Southfield, MI 48034-1097 | 2019-12-06 |
| 1508416355 | Stephanie Lauren Marl | Nurse Practitioner | 29800 Adams Dr, Gibraltar, MI 48173 | 2019-09-13 |
| 1457905614 | Natalie Poole | Nurse Practitioner | 23077 Greenfield Rd Ste 260, Southfield, MI 48075-3745 | 2019-07-26 |
| 1629535117 | Valerie Baunoch | Nurse Practitioner | 2057 E West Maple Rd, Commerce Twp, MI 48390 | 2019-02-21 |
| 1790293488 | Infinity Hope Center LLC | Nurse Practitioner | 260 Vinewood St Ste 100a8919, Detroit, MI 48216-1667 | 2018-01-16 |
| 1033659644 | Anne Zamler | Nurse Practitioner | 14230 W Mcnichols Rd, Detroit, MI 48235-3912 | 2017-03-01 |
| 1396289120 | Next Level Up Health & Wellness Inc. | Nurse Practitioner | 28423 Parkwood St, Inkster, MI 48141-1669 | 2016-12-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.