Alexander Dominique Walters

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

4490 Washington Rd Ste 14
Evans, GA 30809-5898

Phone

(706) 250-0022

Fax

(706) 826-2771

NPI assigned

Nov 19, 2025

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Shawn Bohanan Behavioral Consultation, LLC

  • Community/Behavioral Health Agency
  • Augusta, GA
  • NPI 1295143097
  NPD

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

{
    "created_epoch": "1763510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763510400000",
    "number": "1326909458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 AUGUSTA WEST PKWY STE 1B",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309091808",
            "telephone_number": "706-826-2770",
            "fax_number": "706-826-2771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4490 WASHINGTON RD STE 14",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308095898",
            "telephone_number": "706-250-0022",
            "fax_number": "706-826-2771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "ALEXANDER",
        "middle_name": "DOMINIQUE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-11-19",
        "last_updated": "2025-11-19",
        "certification_date": "2025-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Lynne Walker, PTA
• Krystal Ann Wall, FNP-C
• Brett Wallentine, MD
• Adam David Waller, M.D.
• Amy Walsh
• Elayne Wang, DDS
• Lisa Marie Wannamaker, D.O.
• Jennifer Ward, D.O.
• Stephen Paul Warren, NP-C
• Teresa Annette Watts, DNP, FNP-C

• All providers in Evans, GA
• Behavior Technician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2025; 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.