GRAHAM CLOVERLEAF OPTICAL INC.
NPI 1760627376
Optometrist in Van Buren, AR

Q: What is Graham Cloverleaf Optical Inc.'s NPI number?

The NPI number for Graham Cloverleaf Optical Inc. is 1760627376. It was assigned to this organization in the NPPES registry on December 10, 2008.

Q: What is Graham Cloverleaf Optical Inc.'s specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Active since December 10, 2008

113 N PLAZA CT, VAN BUREN, AR 72956(479) 474-7878(479) 471-1476 Get Directions Write a Review

NPPES record last updated: May 15, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 15, 2024, May 16, 2019 (2 updates tracked since 2019).

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About Graham Cloverleaf Optical Inc. NPPES

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

GRAHAM CLOVERLEAF OPTICAL INC. (NPI 1760627376) is a healthcare organization registered as an optometrist in Van Buren, Arkansas and active in the NPI registry since December 2008. The organization lists Kelly L Graham, Owner/optometrist, as its authorized official.

NPPES Registry Identity

NPI1760627376

Entity TypeOrganization

Primary Taxonomy152W00000X

Legal Business NameGRAHAM CLOVERLEAF OPTICAL INC.

Location Address113 N PLAZA CTVan Buren, AR 72956-2269

Mailing Address113 N Plaza CtVan Buren, AR 72956-2269 · (479) 474-7878 · Fax (479) 471-1476

Phone(479) 474-7878

Fax(479) 471-1476

Organization SubpartNo

Authorized OfficialKelly L GrahamOwner/optometrist · (479) 474-7878

Enumeration DateDecember 10, 2008

Last NPPES UpdateMay 15, 20242 updates tracked since enumeration

NPPES CertifiedMay 15, 2024

✔ NPI 1760627376 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

License✔ Licensed in AR · AR2380

Definition

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

113 N PLAZA CT, Van Buren, AR 72956

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Other Identifiers 1

Medicaid171400722AR

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Graham Cloverleaf Optical Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Graham Cloverleaf Optical Inc., which bills Medicare for the services this clinician delivers.

Clinician (1)

Kelly Graham, O.D.

Optometry

NPI 1447239629

113 N PLAZA CT
Van Buren, AR 72956

(479) 474-7878

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Graham Cloverleaf Optical Inc.'s NPI number?

The NPI number for Graham Cloverleaf Optical Inc. is 1760627376. It was assigned to this organization in the NPPES registry on December 10, 2008.

Where is Graham Cloverleaf Optical Inc. located?

Graham Cloverleaf Optical Inc. is located at 113 N Plaza Ct, Van Buren, AR 72956. The listed phone number is (479) 474-7878.

What is Graham Cloverleaf Optical Inc.'s specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Graham Cloverleaf Optical Inc. enrolled in Medicare?

Yes. Graham Cloverleaf Optical Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Graham Cloverleaf Optical Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Optometry) reassigns their Medicare billing to Graham Cloverleaf Optical Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Graham Cloverleaf Optical Inc. was last updated on May 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.