1. Home
  2. Directory
  3. Texas
  4. Lubbock
  5. Student In An Organized Health Care Education Training Program
  6. NPI Profile

DERRICK BENJAMIN GRAHAM MD
NPI 1649917212
Student in an Organized Health Care Education/Training Program in Lubbock, TX

Active since May 16, 2022PECOS Enrolled
3601 4TH ST - STOP 7217, LUBBOCK, TX 79430(806) 743-2020(806) 743-1782 Get Directions Write a Review

NPPES record last updated: May 18, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 18, 2023, May 16, 2022 (2 updates tracked since 2022).

About Derrick Benjamin Graham Md NPPES

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

DERRICK BENJAMIN GRAHAM MD (NPI 1649917212) is an individual student in an organized health care education/training program in Lubbock, Texas, licensed in Texas (BP10080217) and active in the NPI registry since May 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1649917212
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameDERRICK BENJAMIN GRAHAMCredential: MD
Location Address3601 4TH ST - STOP 7217Lubbock, TX 79430-7217
Mailing Address3601 4th St - Stop 7217Lubbock, TX 79430-7217 · (806) 743-2020 · Fax (806) 743-1782
Phone(806) 743-2020
Fax(806) 743-1782
Sole ProprietorNo
Enumeration DateMay 16, 2022
Last NPPES UpdateMay 18, 20232 updates tracked since enumeration
NPPES CertifiedMay 18, 2023
✔ NPI 1649917212 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
License✔ Licensed in TX · BP10080217
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.

3601 4TH ST - STOP 7217, Lubbock, TX 79430
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Derrick Benjamin Graham Md 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.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Derrick Graham's NPI number?

The NPI number for Derrick Graham is 1649917212. It was assigned to this individual provider in the NPPES registry on May 16, 2022.

Where is Derrick Graham located?

Derrick Graham practices at 3601 4th St - Stop 7217, Lubbock, TX 79430. The listed phone number is (806) 743-2020.

What is Derrick Graham's specialty?

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

Is Derrick Graham enrolled in Medicare?

Yes. Derrick Graham is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Derrick Graham was last updated on May 18, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.