Individual provider Active NPI

Mark Lamont Walker, M.D., F.A.C.S.

  • Surgery Physician
  • Atlanta, GA
National Provider Identifier
1356382345
Registry record updated Mar 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
026953 Issued in GA
Practice address
777 Cleveland Ave SW
Suite 305
Atlanta, GA 30315-7129
Phone
(404) 761-7482
Fax
(404) 761-8398
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 026953 GA Primary
Surgical Critical Care Physician 2086S0102X 026953 GA

Addresses

Primary practice location

777 Cleveland Ave SW
Suite 305
Atlanta, GA 30315-7129

Mailing address

777 Cleveland Ave SW
Suite 305
Atlanta, GA 30315-7129
Phone (404) 761-7482

Other identifiers 1

IdentifierTypeStateIssuer
000298284EMedicaidGA

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101217000366 GA Practitioner - General Surgery 4486842424

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427328000000",
    "number": "1356382345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 CLEVELAND AVE SW",
            "address_2": "SUITE 305",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303157129",
            "telephone_number": "404-761-7482",
            "fax_number": "404-761-8398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 CLEVELAND AVE SW",
            "address_2": "SUITE 305",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303157129",
            "telephone_number": "404-761-7482",
            "fax_number": "404-761-8398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "MARK",
        "middle_name": "LAMONT",
        "name_prefix": "Dr.",
        "credential": "M.D., F.A.C.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2015-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "026953",
            "primary": true
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "GA",
            "license": "026953",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000298284E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.