Individual provider Active NPI

Dalton Kristofer Hunter, FNP-BC

  • Family Nurse Practitioner
  • Evans, GA
National Provider Identifier
1417690223
Registry record updated Sep 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN265058 Issued in GA
Practice address
4275 Owens Rd
Evans, GA 30809-3066
Phone
(731) 394-1145
NPI assigned
Apr 19, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN265058 GA
Family Nurse Practitioner 363LF0000X RN265058 GA Primary

Addresses

Primary practice location

4275 Owens Rd
Evans, GA 30809-3066

Mailing address

PO Box 269084
Oklahoma City, OK 73126-9084
Phone (731) 394-1145

Other practice location 1

1600 Anthony Rd
Augusta, GA 30904-4824
Phone (731) 394-1145

Other practice location 2

3618 J Dewey Gray Cir
Augusta, GA 30909-1867
Phone (731) 394-1145

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220510002104 GA Practitioner - Nurse Practitioner 6709263874 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ultra Health Providers II LLCGroup PAC ID 5395284616, 39 clinicians
Ultra Health LLCGroup PAC ID 6800186602, 151 clinicians

Practice addresses (Care Compare)

1600 Anthony Rd
Augusta, GA 30904-4824
Phone (731) 394-1145

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN265058GAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ultra Health LLC CurrentSince Jan 17, 2024 Accepting new patients
Ultra Health Providers II LLC CurrentSince Jul 12, 2024 Accepting new patients
Statesboro Hma Physician Management LLC Acute Care CurrentSince May 2, 2022 Accepting new patients

Locations

3618 J Dewey Gray Cir
Augusta, GA 30909
Phone (706) 520-7442

1600 Anthony Rd
Augusta, GA 30904
Phone (706) 738-3301

1901 W Screven St
Quitman, GA 31643
Phone (229) 263-6100

1499 Fair Rd
Statesboro, GA 30458
Phone (912) 486-1000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14578/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1650326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790294400000",
    "number": "1417690223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 269084",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731269084",
            "telephone_number": "731-394-1145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4275 OWENS RD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093066",
            "telephone_number": "731-394-1145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 Anthony Rd",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309044824",
            "country_code": "US",
            "telephone_number": "731-394-1145",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3618 J Dewey Gray Cir",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309091867",
            "country_code": "US",
            "telephone_number": "731-394-1145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUNTER",
        "first_name": "DALTON",
        "middle_name": "KRISTOFER",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-19",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN265058",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN265058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans, GA

Sources for this page

Verify at the official NPI Registry.