EVAN NICOLE GRAHAM MD
NPI 1346944584
Student in an Organized Health Care Education/Training Program in Douglasville, GA

Q: What is Evan Graham's NPI number?

The NPI number for Evan Graham is 1346944584. It was assigned to this individual provider in the NPPES registry on March 30, 2023.

Q: What is Evan 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 Evan Graham was last updated on March 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since March 30, 2023PECOS Enrolled

8954 HOSPITAL DR, DOUGLASVILLE, GA 30134(470) 644-6000 Get Directions Write a Review

NPPES record last updated: March 30, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Evan Nicole Graham Md NPPES

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

EVAN NICOLE GRAHAM MD (NPI 1346944584) is an individual student in an organized health care education/training program in Douglasville, Georgia and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS and is a graduate of Mercer University School Of Medicine (2023).

NPPES Registry Identity

NPI1346944584

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameEVAN NICOLE GRAHAMCredential: MD

Location Address8954 HOSPITAL DRDouglasville, GA 30134-2272

Mailing Address8954 Hospital DrDouglasville, GA 30134-2272

Phone(470) 644-6000

Sole ProprietorYes

Medical School CMSMercer University School Of MedicineGraduated 2023

Enumeration DateMarch 30, 2023

NPPES CertifiedMarch 30, 2023

✔ NPI 1346944584 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.

8954 HOSPITAL DR, Douglasville, GA 30134

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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)

Evan Nicole Graham Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9335610716

PECOS Enrollment IDI20260605003509

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.

AMPARO PYRONNEAU NP

Nurse Practitioner (Family)

8954 HOSPITAL DR, BUILDING B, SUITE 115
DOUGLASVILLE, GA 30134

Douglas County (770) 874-5400

MS. SARAH MURPHY MSPAS, PA-C

Physician Assistant (Medical)