OCTAVIA LAWTON GRAHAM (MD) – Family Medicine Physician, NPI 1134581549

OCTAVIA LAWTON GRAHAM (MD) is a healthcare provider. based in Lewisburg, Tennessee. specializing in Family Medicine Physician. They hold the professional credentials MD. They hold a License No. 008710 (GA). The NPI Number for OCTAVIA LAWTON GRAHAM (MD) is 1134581549

Main info

Female
10 Years Of Experience
Name
OCTAVIA LAWTON GRAHAM (MD)
NPI
1134581549
Phone
(931) 359-0019
Address
1090 N Ellington Pkwy Ste 102
Enumeration Date
24 March 2016
Last Update Date
10 January 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9313590019
Graduation Year
2016 (10 years ago)
PAC ID
9830441658
Group Practice PAC ID
4688569718
Professional Enrollment ID
I20190920002904
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience58
Completeness75
Years active:10State licenses:2Digital endpointsOther names

Provider Addresses for OCTAVIA LAWTON GRAHAM (MD)

  • 1090 N Ellington Pkwy Ste 102

    Lewisburg, TN 370912227

    Phone: (931) 359-0019

    Fax: (931) 359-7381

    Type: Location

  • 102, North Ellington Parkway, Wallace Acres, Lewisburg, Marshall County, Tennessee, 37091, United States

    LEWISBURG, TN 370912227

    Phone: (931) 359-0019

    Fax: (931) 359-7381

    Type: Mailing

  • 5962 ZEBULON RD # 186

    MACON, GA 312102099

    Phone:

    Type: Mailing

  • 9475 US-19

    ZEBULON, GA 30295

    Phone: (404) 321-6111

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-09-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190920002904IFamily PracticeTNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 37091)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4688569718View full group profile
NameSpecialtyState
-TN
P S Y C H I A T R YMA
-TN
Physician AssistantTN
Physician AssistantTN
Nurse PractitionerTN
Clinical Social WorkerTN
Physician AssistantTN
-TN
Nurse PractitionerTN

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What is the registry number for OCTAVIA LAWTON GRAHAM (MD)?
The registry entry for OCTAVIA LAWTON GRAHAM (MD) shows NPI 1134581549.
Should I treat OCTAVIA LAWTON GRAHAM (MD) as an active provider?
Patients and plans typically see OCTAVIA LAWTON GRAHAM (MD) as active in the national extract.
How should patients interpret OCTAVIA LAWTON GRAHAM (MD)'s specialty?
The extract shows Family Medicine Physician for OCTAVIA LAWTON GRAHAM (MD). Clinical services aligned with this taxonomy classification.
Which community is linked to OCTAVIA LAWTON GRAHAM (MD)?
OCTAVIA LAWTON GRAHAM (MD) shows a connection to Lewisburg, Tennessee in registry-derived data.
Who maintains OCTAVIA LAWTON GRAHAM (MD)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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