CLARENCE DANTE GRAHAM
NPI 1346082450
Student in an Organized Health Care Education/Training Program in Saint Louis, MO

Q: What is Clarence Graham's NPI number?

The NPI number for Clarence Graham is 1346082450. It was assigned to this individual provider in the NPPES registry on June 10, 2024.

Q: What is Clarence Graham's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Clarence Graham was last updated on April 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 10, 2024PECOS Enrolled

660 S EUCLID AVE, SAINT LOUIS, MO 63110(920) 382-2328 Get Directions Write a Review

NPPES record last updated: April 2, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 2, 2025, Jun 10, 2024 (2 updates tracked since 2024).

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About Clarence Dante Graham NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLARENCE DANTE GRAHAM (NPI 1346082450) is an individual student in an organized health care education/training program in Saint Louis, Missouri and active in the NPI registry since June 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1346082450

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameCLARENCE DANTE GRAHAM

Location Address660 S EUCLID AVESaint Louis, MO 63110-1010

Mailing Address925 N 87th StMilwaukee, WI 53226-4812 · (920) 382-2328

Phone(920) 382-2328

Sole ProprietorNo

Enumeration DateJune 10, 2024

Last NPPES UpdateApril 2, 20252 updates tracked since enumeration

NPPES CertifiedApril 2, 2025

✔ NPI 1346082450 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

660 S EUCLID AVE, Saint Louis, MO 63110

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Clarence Dante Graham is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WUSM BJC ACO PROVIDERS

Clinic/Center (Multi-Specialty)

660 S EUCLID AVE, CAMPUS BOX 8081
SAINT LOUIS, MO 63110

St. Louis City (314) 273-0770

ANDREA YUE-EN SUN MD

Student in an Organized Health Care Education/Training Program