Individual provider Active NPI

Tamala Walton-Sampson, D.P.M

  • Podiatrist
  • Rome, GA
National Provider Identifier
1326350075
Registry record updated Jan 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
POD001225 Issued in GA
Practice address
101 John Maddox Dr NW
Suite a
Rome, GA 30165-1419
Phone
(706) 232-6739
NPI assigned
Jul 10, 2010
Last updated
Jan 4, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X POD001225 GA Primary

Addresses

Primary practice location

101 John Maddox Dr NW
Suite a
Rome, GA 30165-1419

Mailing address

101 John Maddox Dr NW
Suite a
Rome, GA 30165-1419
Phone (706) 232-6739

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130910000205 GA Practitioner - Podiatry 2668616889 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Special Care Podiatry of Georgia LLCGroup PAC ID 4880913490, 10 clinicians

Practice addresses (Care Compare)

40 Technology Pkwy S
Suite 300
Norcross, GA 30092-2924
Phone (248) 528-2116

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1217
Removal or shaving of skin growth75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
POD001225GAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Foot and Ankle Specialist of Georgia, LLC Podiatrist CurrentSince Oct 29, 2016 Accepting new patients
Foot, Ankle & Leg Center of Rome LLC CurrentSince Jul 22, 2013 Accepting new patients
Special Care Podiatry of Georgia, LLC Podiatrist CurrentSince Mar 1, 2024 Accepting new patients
Diabetic Foot and Ankle Clinic of Georgia, Inc Podiatrist PastSince Jul 22, 2013 Accepting new patients

Locations

3400 Chapel Hill Rd
Ste 321
Douglasville, GA 30135
Phone (678) 741-5346

101 John Maddox Dr NW
Ste A
Rome, GA 30165
Phone (678) 489-6589

4350 Brownsboro Rd
Ste 210
Louisville, KY 40207
Phone (830) 212-1661

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1278720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451865600000",
    "number": "1326350075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 JOHN MADDOX DR NW",
            "address_2": "SUITE A",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651419",
            "telephone_number": "706-232-6739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 JOHN MADDOX DR NW",
            "address_2": "SUITE A",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651419",
            "telephone_number": "706-232-6739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTON-SAMPSON",
        "first_name": "TAMALA",
        "name_prefix": "Dr.",
        "credential": "D.P.M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-10",
        "last_updated": "2016-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "POD001225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.