MR. NICHOLAS JAMES GRAHAM (NPI# 1730317728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730317728 |
| Entity Type | Individual |
| Full Name | MR. NICHOLAS JAMES GRAHAM |
| Credential | IDMT |
| Practice Address |
2504 S.chicago St Fairchild Afb WA 99011 |
| Mailing Address |
4320 W.deska Dr Apt 601 Spokane WA 99224 |
| Practice Telephone | 5096575414 |
| Mailing Telephone | 3607011192 |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2009-06-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1003X |
Military Health Care Provider Specialization: Independent Duty Medical Technicians |
Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700439924 | Nicholas John Graham | Counselor | 123 22nd St, Toledo, OH 43604-2706 | 2019-07-17 |
| 1780034272 | Nicholas Graham | Counselor | 295 E Williams Ave, Fallon, NV 89406-3020 | 2016-06-15 |
| 1477939841 | Nicholas L Graham | Physical Therapist | 1710 W 1st St Ste D, Cedar Falls, IA 50613 | 2015-08-07 |
| 1679959266 | Nicholas Graham | Pharmacist | 2293 Upton Dr, Virginia Beach, VA 23454-1186 | 2015-08-05 |
| 1104137447 | Nicholas D Graham | Optometrist | 855 Sam Newell Rd, Suite 203, Matthews, NC 28105-7593 | 2010-06-30 |
| Street Address |
2504 S.CHICAGO ST |
| City | FAIRCHILD AFB |
| State | WA |
| Zip Code | 99011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669939732 | Ruth Ann Sunde | Social Worker | 92d Medical Group/sgow, 701 Hospital Loop, Suite 259, Fairchild Afb, WA 99011 | 2019-02-26 |
| 1164992491 | Michael Thomas Stevens | Military Health Care Provider | 100 Hospital Loop, Fairchild Afb, WA 99011 | 2018-11-29 |
| 1174032569 | Elizabeth Andrews | Registered Nurse | 400 W Fairchild Highway, Fairchild Afb, WA 99011 | 2017-09-28 |
| 1770031171 | Mariah Combs | Behavioral Analyst | 5298 B Sycamore Street, Fairchild Afb, WA 99011 | 2016-09-14 |
| 1770960957 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 101 W. Spaatz Rd., Bldg 2465, Fairchild Afb, WA 99011 | 2015-04-27 |
| 1306191689 | Patricia Kaye Catrow | Family Medicine | 701 Hospital Loop Bldg 9000, Fairchild Afb, WA 99011 | 2012-07-23 |
| 1205102761 | 92nd Medical Group | Military/U.S. Coast Guard Pharmacy | 103 Saatz Rd, Fairchild Afb, WA 99011 | 2012-03-29 |
| 1992078554 | Alyssa Marie Degeyter | Community Health Worker | 7272 A Nebraska Ave, Fairchild Air Force Base, WA 99011 | 2012-02-13 |
| 1922232099 | Pocco S Bussey | Military Health Care Provider | 92 Medical Group, Flight Medicine Clinic, Fairchild, WA 99011 | 2009-05-05 |
| 1043403603 | Alyson L Kresser | Nutritionist | 92 Amds/sgpz, 701 Hospital Loop, Fairchild Air Force Base, WA 99011 | 2007-08-27 |
| Find all providers in zip 99011 | ||||
| Taxonomy Code | 1710I1003X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Medical Technicians |
| An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians. |
| Notes: Source: Air Force Surgeon General Office [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790236503 | Mark Friskel | Military Health Care Provider | 5759a Fort Wright Oval, Fairchild Afb, WA 99011-2203 | 2016-10-17 |
| 1730691148 | Bryce Ferland | Military Health Care Provider | 701 Hospital Loop, Fairchild Afb, WA 99011-8704 | 2017-10-26 |
| 1427574235 | Marissa Dotson | Military Health Care Provider | 701 Hospital Loop Bldg 9000, Fairchild Afb, WA 99011-8704 | 2017-08-15 |
| 1184166977 | Nathan James Dillow | Military Health Care Provider | 701 Hospital Loop, Fairchild Afb, WA 99011-8704 | 2016-11-09 |
| 1801241476 | Nicholas Forster-curnew | Military Health Care Provider | 701 Hospital Loop, Fairchild Afb, WA 99011-8704 | 2016-05-02 |
| 1144657156 | Marc Palmones Villano | Military Health Care Provider | 701 Hospital Loop Bldg 9000, Fairchild Afb, WA 99011-8704 | 2013-10-04 |
| 1205108693 | Samantha Crucet | Military Health Care Provider | 701 Hospital Loop, Fairchild Afb, WA 99011 | 2012-02-01 |
| 1487926879 | Lafe Hernandez | Military Health Care Provider | 701 Hospital Loop, Fairchild Afb, WA 99011-8704 | 2012-02-01 |
| 1417255860 | April Lynn Witt | Military Health Care Provider | 701 Hospital Loop, Fairchild Afb, WA 99011-8704 | 2011-03-09 |
| 1427368950 | Ryan Werner | Military Health Care Provider | 701 Hospital Loop, Fairchild Afb, WA 99011-8704 | 2010-10-18 |
| Find all providers in FAIRCHILD AFB | ||||
| City | FAIRCHILD AFB |
| Zip Code | 99011 |
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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.