Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Blake Graham

Individual provider Physical Therapist · NPI 1376273557

Blake Graham is a Physical Therapist in Private Practice in Edmond, Oklahoma. Qualified in 2022, 4 years ago. Practices with Function Physical Therapy, LLC, a 5-clinician group and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
4
Licensed in
OK
In the registry since
2022
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Practice location Address checks out

16502 N Pennsylvania Ave Ste C
Edmond, OK 73012-9126
Phone: (405) 285-9659
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 6164 (OK)

Record details

NPI number1376273557
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 12, 2022
Last updated in NPPESJune 12, 2022
Certification dateJune 12, 2022
Mailing address16502 N Pennsylvania Ave Ste C, Edmond, OK 73012-9126

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Function Physical Therapy, Llc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Edmond