Individual provider Active NPI

George Dexter Walcott Jr., MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Montgomery, AL
National Provider Identifier
1376520742
Registry record updated Apr 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
23247 Issued in AL
Practice address
4294 Lomac St
Montgomery, AL 36106-3604
Phone
(334) 274-9000
Fax
(334) 274-0857
NPI assigned
Dec 28, 2005
Last updated
Apr 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 23247 AL
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 23247 AL Primary

Addresses

Primary practice location

4294 Lomac St
Montgomery, AL 36106-3604

Mailing address

PO Box 370
Fortson, GA 31808-0370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20100908000053 AL Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 9436220951 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Orthopedic Surgery
Education
University of Mississippi School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hughston Clinic PCGroup PAC ID 1355254780, 111 clinicians

Practice addresses (Care Compare)

4294 Lomac St
Montgomery, AL 36106-3604
Phone (334) 274-9000

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Hughston Clinic, P.C. Orthopaedic Surgery CurrentSince May 1, 2022 Accepting new patients
Hughston Clinic, PC Orthopaedic Surgery CurrentSince May 1, 2022 Accepting new patients
Mississippi Sports Medicine & Orthopaedic Center Orthopaedic Surgery Past Accepting new patients
Hughston Orthopaedic Southeast PC Orthopaedic Surgery PastSince Jun 1, 2022 Accepting new patients

Locations

161 E University Dr
Auburn, AL 36832
Phone (334) 699-5747

4294 Lomac St
Montgomery, AL 36106
Phone (205) 933-8588

461 E Main St
Prattville, AL 36067
Phone (334) 358-0450

277 Huntress St
Wetumpka, AL 36092
Phone (334) 277-3332

277 Huntress St
Ste 202
Wetumpka, AL 36092

Interoperability endpoints

  • Direct secure messaging: george.walcott.1@321.direct.athenahealth.com

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1376520742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "FORTSON",
            "state": "GA",
            "postal_code": "318080370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4294 LOMAC ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361063604",
            "telephone_number": "334-274-9000",
            "fax_number": "334-274-0857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALCOTT",
        "first_name": "GEORGE",
        "middle_name": "DEXTER",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-28",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AL",
            "license": "23247",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "AL",
            "license": "23247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.