Jacqueline Mache Walters, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

040275 Issued in GA

Practice address

3630 Savannah PL Ste 100
Duluth, GA 30096-5028

Phone

(678) 474-0203

Fax

(678) 474-0207

NPI assigned

Sep 9, 2005

Last updated

Jan 30, 2018By the provider in NPPES

Sex

Female

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2014 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Atlanta Women's Health Group, P.C.

  • Specialist
  • Atlanta, GA
  • NPI 1174501902
  NPD (past)
• Northside Hospital, Inc.

  dba Northside Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  NPD (past)
• Northside Northpoint OB GYN 2 LLC

  • Obstetrics & Gynecology Physician
  • Atlanta, GA
  • NPI 1023148616
  NPD (past)
• Women's Healthcare Associates of Athens, LLC

  • Obstetrics & Gynecology Physician
  • Athens, GA
  • NPI 1033618806
  NPD (past)
• Lima Memorial Joint Operating Company

  dba Lima Memorial Health System

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517270400000",
    "number": "1285628891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5780 PEACHTREE DUNWOODY RD STE 300",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421513",
            "telephone_number": "404-303-1224",
            "fax_number": "404-303-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3630 SAVANNAH PL STE 100",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300965028",
            "telephone_number": "678-474-0203",
            "fax_number": "678-474-0207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "JACQUELINE",
        "middle_name": "MACHE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-09",
        "last_updated": "2018-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "040275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000750241D",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTOUT",
            "identifier": "GRP3569",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Basyaw Walker
• Chantelle Walker, LPC, NCC
• Jamila Walker, DC
• Kevin W Walls, DDS
• Gia Walters
• Dong Wang, M.D.
• Hong Wang, MD, PHD
• Jue Wang
• Linda Wang, RPH
• Regina Jianhua Wang, M.D.

• Obstetrics & Gynecology Physician in Duluth, GA
• Providers in Duluth, GA by specialty
• Obstetrics & Gynecology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.