David J Walters, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

043811 Issued in GA

Practice address

1507 Alice St
Waycross, GA 31501-4530

Phone

(912) 283-7220

Fax

(912) 283-7026

NPI assigned

May 1, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Waycross Family Practice

  • Family Medicine Physician
  • Waycross, GA
  • NPI 1891752473
  NPD
• McKinney Community Health Ctr, Inc

  • Federally Qualified Health Center (FQHC)
  • Blackshear, GA
  • NPI 1568623346
  NPD (past)
• McKinney Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Alma, GA
  • NPI 1134454911
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265846400000",
    "number": "1114985231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86067 SHELTER ISLAND DR",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320348153",
            "telephone_number": "904-225-8477",
            "fax_number": "912-283-7026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 ALICE ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315014530",
            "telephone_number": "912-283-7220",
            "fax_number": "912-283-7026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "DAVID",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2010-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "043811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000756313A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co
• Samantha Walker
• Tina Fawn Walker, FNP
• Caitlyn Deanna Walsh, FNP-BC
• Anthony Joseph Walters, CLINICAL SOCIAL WORK
• Ware County Board of Commissioners
• Ware County Board of Education
• Ware County Board of Health
• Ware County Board of Health
• Ware County Board of Health

• Family Medicine Physician in Waycross, GA
• Providers in Waycross, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.