KEITH ALLEN GRAHAM (NPI# 1447735907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447735907 |
| Entity Type | Individual |
| Full Name | KEITH ALLEN GRAHAM |
| Credential | ATC/L |
| Practice Address |
8 Medical Park Drive Suite 100 Malta NY 12020 |
| Practice Telephone | 5183638710 |
| Mailing Telephone | 5183638710 |
| Enumeration Date | 2018-10-01 |
| Last Update Date | 2018-10-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
104.0000102 | VT | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
003760-1 | NY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902438161 | Keith Edward Graham | Peer Specialist | 37450 Schoolcraft Rd Ste 110, Livonia, MI 48150-1000 | 2020-02-06 |
| 1639651805 | Keith Stephen Graham | Pharmacist | 400 Highland Ave, Geisinger Lewistown Hospital Pharmacy, Lewistown, PA 17044 | 2018-09-04 |
| Street Address |
8 MEDICAL PARK DRIVE SUITE 100 |
| City | MALTA |
| State | NY |
| Zip Code | 12020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962971663 | Saratoga Hospital | Family Medicine | 8 Medical Park Drive, Suite 100, Malta, NY 12020-5050 | 2018-11-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811529415 | Peter Joseph Valastro Jr. | Registered Nurse | 2452 Us Rt 9 Suite 206, Malta, NY 12020 | 2020-02-11 |
| 1083257224 | Martins Foods of South Burlington LLC | Durable Medical Equipment & Medical Supplies | 3 Via Rossi Way, Ballston Spa, NY 12020 | 2019-10-21 |
| 1528542255 | Mary Szacik | Social Worker | 2452 Us Rt. 9, Suite 206, Malta, NY 12020 | 2018-09-19 |
| 1669966867 | Adam Smatko | Social Worker | 2452 Us Route 9, Suite 206, Malta, NY 12020 | 2018-06-20 |
| 1538665104 | Tressa Frese | Counselor | 35 Bath Street, Ballston Spa, NY 12020 | 2018-04-03 |
| 1902312556 | Maltavista Optometry, Pllc | Optometrist | 2715 Rt 9, Suite 204, Malta, NY 12020 | 2017-12-19 |
| 1497207294 | Julie Lapham | Counselor | 100 Saratoga Village Blvd. Suite 26, Malta, NY 12020 | 2016-10-27 |
| 1932656527 | Matthew Kattell | Physical Therapist | 4102 Ellsworth Boulevard, Malta, NY 12020 | 2016-09-01 |
| 1295134740 | Nnenna Lindsay | Psychologist | 15 Trieble Avenue, Suite 5 Pmb 1013, Ballston Spa, NY 12020 | 2014-08-21 |
| 1023425956 | Jessica Duell | Registered Nurse | 603 Sweetman Road, Ballston Spa, NY 12020 | 2014-07-11 |
| Find all providers in zip 12020 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336613199 | Tyson Copenhaver Carney | Specialist/Technologist | 631 S 6th Ave E, Malta, MT 59538-8893 | 2019-01-15 |
| 1477195063 | Katherine Hamel | Specialist/Technologist | 8 Medical Park Dr, Malta, NY 12020-5050 | 2019-10-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639779309 | Jonathan Edwards | Specialist/Technologist | 39 Monty St, Plattsburgh, NY 12901-3702 | 2020-10-30 |
| 1245830207 | Skyler Lauren Cirillo | Specialist/Technologist | 1000 Hempstead Turnpike, Hempstead, NY 11549-0001 | 2020-10-29 |
| 1790384410 | Gina Siracusano | Specialist/Technologist | 630 Mastic Rd Ste 4, Mastic Beach, NY 11951-1020 | 2020-10-23 |
| 1134728504 | Corinne Edwards | Specialist/Technologist | 3606 Nutt Rd, Jamestown, NY 14701-9432 | 2020-10-18 |
| 1720687163 | Theresa A Trump | Specialist/Technologist | 7 Mapleline Rd, Ballston Lake, NY 12019-1589 | 2020-10-17 |
| 1235738667 | Erica Michalski | Specialist/Technologist | 157 Hillpine Rd, Cheektowaga, NY 14227-2261 | 2020-10-17 |
| 1396344743 | Jared Russom | Specialist/Technologist | 13 Brookview Ave., Delmar, NY 12054 | 2020-10-17 |
| 1720686231 | Leighann Buzzard | Specialist/Technologist | 277 Forbes Ave, Tonawanda, NY 14150-4705 | 2020-10-16 |
| 1861090367 | Jake Savino | Specialist/Technologist | 185 Oak Ave, Staten Island, NY 10306-4002 | 2020-10-15 |
| 1992303572 | Elise Fitzsimmons | Specialist/Technologist | 9 Laker Hall, Oswego, NY 13126 | 2020-10-15 |
| 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.