MARY L GRAHAM (NPI# 1558992065) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558992065 |
| Entity Type | Individual |
| Full Name | MARY L GRAHAM |
| Practice Address |
4220 Burton St Se Grand Rapids MI 49546-6121 |
| Practice Telephone | 6167261985 |
| Mailing Telephone | 6167261985 |
| Enumeration Date | 2020-02-03 |
| Last Update Date | 2020-02-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3747P1801X |
Technician Specialization: Personal Care Attendant |
Nursing Service Related Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629693270 | Mary Briggs Graham | Speech-Language Pathologist | 445 Porterfield Hwy Sw Ste B, Abingdon, VA 24210-2583 | 2020-06-10 |
| 1033732615 | Mary Amanda Graham | Counselor | 510 S 35th St, Tacoma, WA 98418-6824 | 2020-05-18 |
| 1528617164 | Mary Liz Graham | Counselor | 4124 Mission Trace Blvd, Tallahassee, FL 32303-1702 | 2019-09-06 |
| 1265835607 | Mary Anna Graham | Licensed Practical Nurse | 92 Malden Ave, Palenville, Palenville, NY 12463-2511 | 2014-09-30 |
| 1437563111 | Mary Graham | Licensed Vocational Nurse | 13417 Orourke Dr, Pflugerville, TX 78660-5682 | 2014-06-20 |
| 1508279282 | Mary Graham | Occupational Therapist | 3091 Governors Lake Dr, Suite 580, Norcross, GA 30071-1143 | 2014-06-10 |
| 1174771422 | Mary Frances Graham | Physical Therapy Assistant | 1901 N. 13th Street, Herrin, IL 62948 | 2008-08-28 |
| 1932360534 | Mary Graham | Social Worker | 16 Acadia Shrs, Woolwich, ME 04579-4574 | 2008-06-17 |
| 1730112954 | Mary Lynn Graham | Audiologist-Hearing Aid Fitter | 1316 Rock Cliff Dr, Martinsburg, WV 25401-3278 | 2006-07-09 |
| 1811995103 | Mary Lou Graham | Nurse Practitioner | 14 Cedar St, New Britain, CT 06052-1302 | 2005-07-11 |
| Street Address |
4220 BURTON ST SE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49546-6121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326518531 | Neah Morgan | Technician | 4220 Burton St Se, Grand Rapids, MI 49546 | 2018-11-29 |
| 1912557943 | Aleisha Joy Kole | Technician | 4220 Burton St Se, Grand Rapids, MI 49546-6121 | 2019-09-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437762986 | Amanda Mae Ostrom | Speech-Language Pathologist | 710 Kenmore Ave Se, #110, Grand Rapids, MI 49546 | 2020-08-25 |
| 1063075562 | Kelly Lynn Ibarra | Counselor | 4467 Cascade Road Se, Suite #4479, Grand Rapids, MI 49546 | 2019-04-19 |
| 1891257036 | Jessica Matthews LLC | Counselor | 4127 Embassy Drive Se, Grand Rapids, MI 49546 | 2019-04-05 |
| 1316430267 | Michael John Benskey | Case Manager/Care Coordinator | 4065 Saladin St Se, Grand Rapids, MI 49546 | 2018-06-14 |
| 1679062772 | Smile Cascade, P.C. | Clinic/Center | 4505 Cascade Rd Se # A, Grand Rapids, MI 49546 | 2018-05-03 |
| 1720583289 | Jeromy Krogman | Counselor | 826 Parchment Drive Se, Grand Rapids, MI 49546 | 2018-03-27 |
| 1841792660 | Affordable Hearing Clinic | Hearing Instrument Specialist | 833 Kenmoor Ave Se Ste G, Grand Rapids, MI 49546 | 2018-03-07 |
| 1689176133 | Kelly Pines | Physical Therapist | 625 Kenmoor Ave Suite 306, Grand Rapids, MI 49546 | 2018-03-01 |
| 1467971440 | Deanna Elizabeth Saenz | Social Worker | 2100 Raybrook St Se Ste 300, Grand Rapids, MI 49546 | 2017-09-12 |
| 1730607896 | Kayla Marie Decker | Technician | 2706 Burton Street Se, Grand Rapids, MI 49546 | 2017-09-08 |
| Find all providers in zip 49546 | ||||
| Taxonomy Code | 3747P1801X |
| Grouping | Nursing Service Related Providers |
| Classification | Technician |
| Specialization | Personal Care Attendant |
| An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811503758 | Lynda Poupard | Technician | 12447 S River Rd, Grand Rapids, OH 43522-9604 | 2020-09-16 |
| 1356954705 | Mckenna Shank | Technician | 1409 E Beltline Ave Se, Grand Rapids, MI 49506 | 2020-08-26 |
| 1659983062 | Serena Selwyn | Technician | 2024 Edgewood Ave Se, Grand Rapids, MI 49546-5718 | 2020-08-18 |
| 1235755919 | Michael Scott | Technician | 3608 Camelot Dr Se, Grand Rapids, MI 49546-6072 | 2020-06-18 |
| 1861015075 | Michael Robert Capolino | Technician | 42 Carlton Ave Se, Grand Rapids, MI 49506-1649 | 2020-05-21 |
| 1568082121 | Deenea Forrest | Technician | 3500 Lake Dr Se, Grand Rapids, MI 49546-4310 | 2020-04-23 |
| 1922627983 | Jerica Moet Boss | Technician | 27 Holland Ave Ne, Grand Rapids, MI 49503-3536 | 2020-04-10 |
| 1235766270 | Cherri Apple Jones | Technician | 6281 Skipton Dr Sw, Grand Rapids, MI 49548-6701 | 2020-03-26 |
| 1841836665 | Ahnetra Williams | Technician | 4345 36th St Se, Grand Rapids, MI 49512-2963 | 2019-11-27 |
| 1982251872 | Tanner Jorritsma | Technician | 2037 Cambridge Dr Se, Grand Rapids, MI 49506-5235 | 2019-08-25 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 49546 |
Please comment or provide details below to improve the information on MARY L GRAHAM.
| 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.