Evan Nicole Graham, MD
Individual provider Active NPI Family Medicine Physician · Locust Grove, GA
NPI 1346944584 · NPPES record last updated Aug 27, 2026
Key facts
- NPI
- 1346944584
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 109938 (GA)
- Practice address
- 3366 Highway 42 S Ste 110
Locust Grove, GA 30248-3039 - Phone
- (770) 898-4339
- NPI assigned
- Mar 30, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Mercer University School of Medicine, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
313 Somersby Dr
Dallas, GA 30157-8076
PO Box
Atlanta, GA 30368
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260605003509 | GA | Practitioner - Family Practice | 9335610716 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 109938 | GA | Yes |
Addresses
Primary practice location
3366 Highway 42 S Ste 110
Locust Grove, GA 30248-3039
Mailing address
8954 Hospital Dr
Douglasville, GA 30134-2272
Other practice location 1
8954 Hospital Dr
Douglasville, GA 30134-2272
Phone (470) 644-6000
Other providers in Locust Grove, GA
- Georgia Dental Professionals, PC
- Georgia Primary Care Partners, LLC
- Georgia Psych Services LLC
- Georgia Wellness Services LLC
- Gerizim Health Solutions LLC.
- Great Value Home LLC
- Tammy Green
- Judlande Guervil
- Gregory Bernadas Guinoo
- H.E.a.L. Supply
All providers in Locust Grove, GA · Family Medicine Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 27, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.