DR. LARRY C GRAHAM II (NPI# 1023090503) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023090503 |
| Entity Type | Individual |
| Full Name | DR. LARRY C GRAHAM II |
| Credential | MD |
| Practice Address |
3600 E Harry St Wichita KS 67218-3713 |
| Mailing Address |
13715 Pinnacle Dr Wichita KS 67230-1545 |
| Practice Telephone | 3166895050 |
| Practice Fax Number | 3166896192 |
| Mailing Telephone | 3167332307 |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2013-11-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085B0100X |
Radiology Specialization: Body Imaging |
04-28763 | KS | Allopathic & Osteopathic Physicians |
| N | 2085N0700X |
Radiology Specialization: Neuroradiology |
04-28763 | KS | Allopathic & Osteopathic Physicians |
| N | 2085N0904X |
Radiology Specialization: Nuclear Radiology |
04-28763 | KS | Allopathic & Osteopathic Physicians |
| N | 2085P0229X |
Radiology Specialization: Pediatric Radiology |
04-28763 | KS | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
04-28763 | KS | Allopathic & Osteopathic Physicians |
| N | 2085R0203X |
Radiology Specialization: Therapeutic Radiology |
04-28763 | KS | Allopathic & Osteopathic Physicians |
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
04-28763 | KS | Allopathic & Osteopathic Physicians |
| N | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
04-28763 | KS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100173090A | 05 | |
| MO | 1023090503 | 05 | |
| KS | RR MEDICARE | 300132252 | 01 |
| KS | 100420330C | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710528617 | Larry J Graham Jr. | Community Based Residential Treatment Facility, Mental Illness | 1284 Maurer Ave, Pontiac, MI 48342-1960 | 2019-10-01 |
| 1780784173 | Larry A. Graham | Psychiatry & Neurology | 551 Cincinnati-batavia Pk, Cincinnati, OH 45244 | 2006-09-25 |
| 1255999249 | Larry D Graham | Pharmacist | 1026 Radio Rd, Durant, OK 74701-2991 | 2019-06-04 |
| 1275930554 | Larry David Graham | Surgery | 434 4th St, Newport, TN 37821-3746 | 2014-12-02 |
| 1962798314 | Larry E Graham Jr. | Occupational Therapy Assistant | 820 Camelot Dr, Harlingen, TX 78550-8400 | 2011-06-23 |
| 1871694828 | Larry G Graham | Pathology | 5301 Virginia Way Ste 300, Brentwood, TN 37027-7542 | 2006-09-25 |
| 1669572178 | Larry Lloyd Graham | Dentist | 1050 Wishard Blvd, Rm. 4201, Indianapolis, IN 46202-2872 | 2006-09-24 |
| Street Address |
3600 E HARRY ST |
| City | WICHITA |
| State | KS |
| Zip Code | 67218-3713 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629073812 | Philippe Samson | Pediatrics | 3600 E Harry St, Wichita, KS 67218-3713 | 2005-06-15 |
| 1326664822 | Boaz B Beard | Physical Therapist | 3600 E Harry St, Wichita, KS 67218-3713 | 2020-06-19 |
| 1932680071 | Nathen D Yunker | Registered Nurse | 3600 E Harry St, Wichita, KS 67218-3713 | 2018-08-27 |
| 1730697012 | Ryan Patrick Prebble | Nurse Practitioner | 3600 E Harry St, Wichita, KS 67218-3713 | 2018-01-20 |
| 1730699844 | Anna Marie Sewell | Nurse Practitioner | 3600 E Harry St, Wichita, KS 67218-3713 | 2017-10-03 |
| 1598145005 | Ascension Via Christi Imaging Wichita, LLC | Radiology | 3600 E Harry St, Wichita, KS 67218-3713 | 2015-06-01 |
| 1659768125 | Cep America-kansas, LLC | Emergency Medicine | 3600 E Harry St, Wichita, KS 67218-3713 | 2015-04-22 |
| 1942696497 | Erik Dill | Pathology | 3600 E Harry St, Wichita, KS 67218-3713 | 2015-04-11 |
| 1649616988 | Kathryn M Fulghum | Nurse Practitioner | 3600 E Harry St, Wichita, KS 67218-3713 | 2013-05-14 |
| 1366888570 | Megan M Frieze | Registered Nurse | 3600 E Harry St, Wichita, KS 67218-3713 | 2013-05-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114544392 | Diana Ho | Optometrist | 980 Oliver Street, Wichita, KS 67218 | 2020-07-03 |
| 1134773690 | Lily Lopez | Nurse's Aide | 5107 E Kellogg Drive, Wichita, KS 67218 | 2019-08-01 |
| 1750862512 | Kelsi Wenger | Student in an Organized Health Care Education/Training Program | 5500 E Kellog Dr, Wichita, KS 67218 | 2018-08-28 |
| 1770038937 | Hair Replacement Clinic | Specialist | 1815 S Windsor, Wichita, KS 67218 | 2016-08-17 |
| 1457757346 | South Wind Women's Centter, LLC | Clinic/Center | 5701 E Kellogg Drive, Wichita, KS 67218 | 2014-11-05 |
| 1124460787 | Teri Kitchen | Social Worker | 3414 Kinkaid, Wichita, KS 67218 | 2013-07-24 |
| 1053660142 | Glenda Rodgers-lawless, Ph.d., Lcpc, Pa | Community/Behavioral Health | 4601 E Douglas, Wichita, KS 67218 | 2012-09-05 |
| 1649541848 | Stephen Rhinehart | Registered Nurse | 5500 E Kellogg Dr., Wichita, KS 67218 | 2012-01-19 |
| 1457666927 | Recovery Services Council Inc. | Point of Service | 1611 South Rutan, Wichita, KS 67218 | 2010-08-09 |
| 1043535867 | Melissa A Weinley | Respiratory Therapist, Registered | 5500 East Kellog Dr, Wichita, KS 67218 | 2010-04-05 |
| Find all providers in zip 67218 | ||||
| Taxonomy Code | 2085B0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Body Imaging |
| A Radiology doctor of Osteopathy that specializes in Body Imaging. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: definiton added, source added] Additional Resources: The American Osteopathic Board of Radiology no longer offers a certificate in this specialty. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346700382 | Rizwan Mohiuddin Zafer | Radiology | 1010 N Kansas St, Wichita, KS 67214-3124 | 2019-03-25 |
| 1598145005 | Ascension Via Christi Imaging Wichita, LLC | Radiology | 3600 E Harry St, Wichita, KS 67218-3713 | 2015-06-01 |
| 1528036399 | Imaging Corporation of Wichita Pa | Radiology | 3333 N Webb Rd, Wichita, KS 67226-8123 | 2006-03-09 |
| 1245208008 | Prairie Creek Imaging LLC | Radiology | 500 S Main St, Wichita, KS 67202-3722 | 2006-03-09 |
| 1558339317 | Glen Shurtz | Radiology | 500 S Main St, Wichita, KS 67202-3722 | 2006-03-09 |
| 1558339325 | Norman Pay | Radiology | 3333 N Webb Rd, Wichita, KS 67226-8123 | 2006-03-09 |
| 1831166537 | Ams Diagnostics, LLC | Radiology | 1035 N Emporia St, Suite 215, Wichita, KS 67214-2944 | 2006-03-02 |
| 1376526327 | James C Degner | Radiology | 3600 E Harry St, Wichita, KS 67218-3713 | 2005-11-23 |
| 1861475048 | Robert A Schmaltz | Radiology | 929 N Saint Francis St, Wichita, KS 67214-3821 | 2005-11-22 |
| 1508849787 | Suryakumar Reddy | Radiology | 929 N Saint Francis St, Wichita, KS 67214-3821 | 2005-11-22 |
| Find all providers in WICHITA | ||||
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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.