Mark C Graves, PT

Individual provider Active NPI Physical Therapist · Lewisburg, TN

NPI 1831226489 · NPPES record last updated Jan 31, 2014

Key facts

NPI
1831226489
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
8683 (TN)
Practice address
870 N Ellington Pkwy
Lewisburg, TN 37091-2271
Phone
(931) 361-4023
Fax
(931) 361-4024
NPI assigned
Feb 28, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Results-Ast JV LLC (390 clinicians)

Practice addresses (Care Compare)

2030 Cowan Hwy
Suite 1
Winchester, TN 37398-2425
Phone (931) 968-1080

712 N Ellington Pkwy
Suite 6
Lewisburg, TN 37091-2454
Phone (931) 359-1913

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20100816000625 TN Practitioner - Physical Therapist in Private Practice 5890829683 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
889TNMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Physical Therapy, LLC Physical Therapist Current
since Jun 30, 2012
Accepting new patients
Results-Ast JV, LLC Physical Therapist Current
since Aug 15, 2022
Accepting new patients
Independent Physical Therapy LLC Physical Therapist Current
since Jun 30, 2012
Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

1202 N Charles G Seivers Blvd
Ste A
Clinton, TN 37716
Phone (865) 457-0192

1420 W Baddour Pkwy
Ste 120
Lebanon, TN 37087
Phone (615) 443-9036

712 N Ellington Pkwy
Ste 6
Lewisburg, TN 37091
Phone (931) 359-1913

870 N Ellington Pkwy
Lewisburg, TN 37091
Phone (931) 361-4023

820 Scenic Hwy
Ste B
Lookout Mtn, TN 37350
Phone (423) 825-1393

8823 Production Ln
Ooltewah, TN 37363
Phone (423) 238-8923

1878 N Main St
Shelbyville, TN 37160
Phone (931) 680-9722

2030 Cowan Hwy
Ste 1
Winchester, TN 37398
Phone (931) 968-1080

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 889 TN
Physical Therapist 225100000X 8683 TN Yes

Addresses

Primary practice location

870 N Ellington Pkwy
Lewisburg, TN 37091-2271

Mailing address

8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-7217

Other identifiers

IdentifierTypeStateIssuer
8683OtherTNPHYSICAL THERAPY LICENSE

Other providers in Lewisburg, TN

All providers in Lewisburg, TN · Physical Therapist in Tennessee

Sources for this page

Verify at the official NPI Registry.