DR. TERRENCE M GRAHAM (NPI# 1972585990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972585990 |
| Entity Type | Individual |
| Full Name | DR. TERRENCE M GRAHAM |
| Credential | DPM,FACFAS |
| Practice Address |
2 Memorial Dr Ste 305 Decatur IL 62526-3999 |
| Mailing Address |
102 W Kenwood Ave Suite 150 Decatur IL 62526-4368 |
| Practice Telephone | 2178764830 |
| Practice Fax Number | 2178768385 |
| Mailing Telephone | 2178753668 |
| Mailing Fax Number | 2178754277 |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2018-02-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
016003032 | IL | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 016003032 | 05 | |
| IL | RR MEDICARE | 480008850 | 01 |
| IL | BCBS | 0060215009 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598942864 | Terrence Wayne Graham | Counselor | 2113 Swimming Hole Cir, Raleigh, NC 27610-5377 | 2008-01-29 |
| Street Address |
2 MEMORIAL DR STE 305 |
| City | DECATUR |
| State | IL |
| Zip Code | 62526-3999 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083957088 | Edward C Elliott IIi | Podiatrist | 2 Memorial Dr Ste 305, Decatur, IL 62526-3999 | 2013-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083100804 | Coalition | Non-emergency Medical Transport (VAN) | 2375 N Longwood Dr, Decatur, IL 62526 | 2018-07-04 |
| 1881116820 | Bria N Howard | Nurse's Aide | 606 E Warren St. Apt 609, Decatur, IL 62526 | 2017-07-12 |
| 1437683679 | Lutheran Child and Family Services | Foster Care Agency | 2826 N. Monroe Street, Decatur, IL 62526 | 2017-04-14 |
| 1083166326 | Whitney Miller | Pharmacist | 225 East Ash Ave, Decatur, IL 62526 | 2016-11-03 |
| 1487053369 | Central Illinois Health Associates, Inc | Preferred Provider Organization | 2300 N. Edward Street, Decatur, IL 62526 | 2014-08-18 |
| 1659787893 | Stephanie Marie Kanitsch | Obstetrics & Gynecology | 544 W Pershing Rd Ste A, Decatur, IL 62526 | 2014-07-09 |
| 1497169973 | Brian Hassinger | Audiologist-Hearing Aid Fitter | 2605 N Water St Ste 101, Decatur, IL 62526 | 2014-06-12 |
| 1891041570 | Decatur 2016 LLC | Dentist | 141 Epershing Rd, Decatur, IL 62526 | 2012-07-31 |
| 1558639005 | Larry Lee Christensen | Pharmacist | 225 Ash Ave, Decatur, IL 62526 | 2011-12-12 |
| 1174821540 | Nathan Pyle | Internal Medicine | 2 Memorial Dr Ste 101, Decatur, IL 62526 | 2011-03-08 |
| Find all providers in zip 62526 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073574083 | Jimmy Lee Gregory | Podiatrist | 3546 Covington Hwy, Suite C, Decatur, GA 30032-1823 | 2006-03-29 |
| 1902886799 | Jerald Noel Kramer | Podiatrist | 215 Clairemont Ave, Decatur, GA 30030-2505 | 2006-01-18 |
| 1699382879 | Roanoke Foot & Ankle Institute, Pllc | Podiatrist | 1713 S Fm 51 Ste 103, Decatur, TX 76234-3644 | 2020-09-30 |
| 1275142473 | Jeanne Marie Louise Mirbey | Podiatrist | 2701 N Decatur Rd, Decatur, GA 30033-5918 | 2020-07-24 |
| 1154941714 | John C Haight | Podiatrist | 2701 N Decatur Rd, Decatur, GA 30033-5918 | 2020-04-23 |
| 1871113787 | Chandler Ligas | Podiatrist | 2701 N Decatur Rd, Decatur, GA 30033-5918 | 2020-04-21 |
| 1144853649 | Charles Penvose | Podiatrist | 2701 N Decatur Rd, Decatur, GA 30033-5918 | 2020-02-13 |
| 1295375269 | Lauren E Kuenzi | Podiatrist | 2701 N Decatur Rd, Decatur, GA 30033-5918 | 2020-01-08 |
| 1689214546 | Hemesath Podiatry Pllc | Podiatrist | 1001 W Eagle Dr, Decatur, TX 76234-3745 | 2020-01-08 |
| 1932673902 | Kelly Brennan | Podiatrist | 2701 N Decatur Rd, Decatur, GA 30033-5918 | 2019-01-14 |
| Find all providers in DECATUR | ||||
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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.