Individual provider Active NPI

Regina Walsh, NP

  • Nurse Practitioner
  • Augusta, GA
National Provider Identifier
1588110431
Registry record updated May 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN210379 Issued in GA
Practice address
3675 J Dewey Gray Cir Ste 300
Augusta, GA 30909-1868
Phone
(706) 863-9595
Fax
(706) 868-8375
NPI assigned
Aug 31, 2016
Last updated
May 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN210379 GA Primary

Addresses

Primary practice location

3675 J Dewey Gray Cir Ste 300
Augusta, GA 30909-1868

Mailing address

PO Box 3726
Augusta, GA 30914-3726
Phone (706) 863-9595

Other identifiers 1

IdentifierTypeStateIssuer
RN210379OtherGAGA LICENSE

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
I20160928001607 GA Practitioner - Nurse Practitioner 6901193358 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Burn Critical Care Associates LLCGroup PAC ID 6204103625, 10 clinicians

Practice addresses (Care Compare)

3651 Wheeler Rd
Burn Unit
Augusta, GA 30909-6521
Phone (706) 651-3232

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN210379GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Burn Critical Care Associates, LLC CurrentSince Feb 1, 2021 Accepting new patients
Hospital Physician Services - Southeast Professional Corporation Nurse Practitioner CurrentSince Sep 25, 2019 Accepting new patients
Central Georiga Fertility Institute Past Accepting new patients

Locations

3614 J Dewey Gray Cir
Ste B
Augusta, GA 30909
Phone (706) 364-3470

3624 J Dewey Gray Cir
Ste 304
Augusta, GA 30909

3651 Wheeler Rd
Augusta, GA 30909
Phone (706) 651-3232

501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291

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.

Hospital & facility affiliations 1

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": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588723200000",
    "number": "1588110431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3726",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309143726",
            "telephone_number": "706-863-9595",
            "fax_number": "706-868-8375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3675 J DEWEY GRAY CIR STE 300",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309091868",
            "telephone_number": "706-863-9595",
            "fax_number": "706-868-8375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "REGINA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-31",
        "last_updated": "2020-05-06",
        "certification_date": "2020-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN210379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA LICENSE",
            "identifier": "RN210379",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.