Mark Allen Graves, FNP-BC
Individual provider Active NPI Family Nurse Practitioner · Lyles, TN
NPI 1881977684 · NPPES record last updated Sep 28, 2011
Key facts
- NPI
- 1881977684
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 16146 (TN)
- Practice address
- 7723 Clearview Church LN
Lyles, TN 37098-1674 - Phone
- (931) 670-5520
- Fax
- (931) 670-5312
- NPI assigned
- Sep 28, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 18
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Vanderbilt University School of Medicine, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Maury Regional Medical Group, Inc
International Falls Memorial Hospital Association
Winner Regional Healthcare Center
Practice addresses (Care Compare)
1222 Trotwood Ave
Suite 101
Columbia, TN 38401-6404
Phone (931) 490-7348
1400 Hwy 71
International Falls, MN 56649-2154
Phone (218) 283-4481
745 E 8TH St
Winner, SD 57580-2677
Phone (605) 842-7100
Hospital & facility affiliations
- Maury Regional Hospital
- Rainy Lake Medical Center
- Winner Regional Healthcare Center - Cah
- Rainy Lake Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in TN, MN, SD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20111109000623 | TN | Practitioner - Nurse Practitioner | 4486827342 | Reassigns benefits to 4 organizations |
| I20180405002127 | MN | Practitioner - Nurse Practitioner | 4486827342 | Reassigns benefits to 2 organizations |
| I20250404002507 | SD | Practitioner - Nurse Practitioner | 4486827342 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16146 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Apogee Medical Group Tennessee PC | Current |
Accepting new patients | |
| Amg Crockett LLC | Family | Current |
Accepting new patients |
| Maury Regional Hospital Marshall Medical Center | Current |
Accepting new patients | |
| Maury Regional Medical Group, Inc | Family | Current |
Accepting new patients |
| Amg-Crockett, LLC | Current |
Accepting new patients | |
| Winner Regional Healthcare Center | Current |
Accepting new patients | |
| International Falls Memorial Hospital Association | Current |
Accepting new patients | |
| Amg-Crockett, LLC | Current | Accepting new patients | |
| Winner Regional Healthcare Center | Current |
Accepting new patients | |
| Tioga Medical Center | Current | Accepting new patients | |
| Southland TN Emergency Medical Services LLC | Current |
Accepting new patients | |
| International Falls Memorial Hospital Association | Current |
Accepting new patients | |
| House Call Medical, LLC | Family | Past | Accepting new patients |
Locations
1400 Highway 71
Intl Falls, MN 56649
Phone (218) 283-4481
745 E 8th St
Winner, SD 57580
Phone (605) 842-2626
1222 Trotwood Ave
Ste 101
Columbia, TN 38401
Phone (931) 490-7348
1218 Trotwood Ave
Columbia, TN 38401
Phone (931) 380-4114
854 W James M Campbell Blvd
Ste 303
Columbia, TN 38401
Phone (931) 388-8779
1607 S Locust Ave
Lawrenceburg, TN 38464
Phone (731) 287-2244
106 S Military St
#B
Loretto, TN 38469
Phone (931) 853-4622
1275 E College St
Ste 2
Pulaski, TN 38478
Phone (931) 363-3514
103 Jv Mangubat Dr
Waynesboro, TN 38485
Phone (931) 722-3404
Interoperability endpoints
- lyi9196@yourcarecommunity.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 16146 | TN | Yes |
Addresses
Primary practice location
7723 Clearview Church LN
Lyles, TN 37098-1674
Mailing address
7723 Clearview Church LN
Lyles, TN 37098-1674
Phone (931) 670-5520
Other providers in Lyles, TN
- Darryl A Bivens
- Community Pharmacy Care, Inc.
- Dialysis Clinic Inc.
- Dickson Medical Associates, PC
- Sarah Whitley Gagnon
- Zilla F Henricksen
- Hickman Community Health Careservices
- KJK LLC
- Brent Lee
- Leah Gordon Lee
All providers in Lyles, TN · Family Nurse Practitioner in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 28, 2011. 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.