J Gregory Waller PC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

000746 Issued in GA

Legal business name

J GREGORY WALLER PC

Practice address

602 Pat Haralson Drive
Blairsville, GA 30512

Phone

(706) 745-6764

NPI assigned

Mar 24, 2008

Last updated

Jul 17, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Candy Beck

Title

Manager

Phone

(706) 745-6764

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• J. Gregory Waller, DPM,P.C.

  • Podiatrist
  • Blairsville, GA
  • NPI 1891714747
  Medicare reassignment NPD

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

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374019200000",
    "number": "1295907848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 PAT HARALSON DR",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305128414",
            "telephone_number": "706-745-6764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 PAT HARALSON DRIVE",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "30512",
            "telephone_number": "706-745-6764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J GREGORY WALLER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-24",
        "last_updated": "2013-07-17",
        "status": "A",
        "authorized_official_last_name": "BECK",
        "authorized_official_first_name": "CANDY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "706-745-6764"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "000746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Podiatrist in Blairsville, GA
• Providers in Blairsville, GA by specialty
• Podiatrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.