Active NPI
Beverly Dianne Walker, M.D.
- Pediatric Adolescent Medicine Physician
- Albany, GA
National Provider Identifier
1629033899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- 20395
- Practice address
- 311 W 2ND Ave
Albany, GA 31701-2369 - Phone
- (229) 883-0537
- Fax
- (229) 883-8831
- NPI assigned
- Apr 19, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | 20395 | GA | Primary |
Addresses
Primary practice location
311 W 2ND Ave
Albany, GA 31701-2369
Mailing address
311 W 2ND Ave
PO Box 70369
Albany, GA 31701-2369
Phone (229) 883-0537
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00178681A | Medicaid | GA | |
| 20395 | Other | GA | MEDICAL LICENSE NO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20395 | GA | MD | Pediatric Adolescent Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beverly D Walker MD | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Albany, GA
- NPI 1679845804
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1629033899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311 W 2ND AVE",
"address_2": "PO BOX 70369",
"city": "ALBANY",
"state": "GA",
"postal_code": "317012369",
"telephone_number": "229-883-0537",
"fax_number": "229-883-8831"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 W 2ND AVE",
"city": "ALBANY",
"state": "GA",
"postal_code": "317012369",
"telephone_number": "229-883-0537",
"fax_number": "229-883-8831"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "BEVERLY",
"middle_name": "DIANNE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-04-19",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "GA",
"license": "20395",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00178681A",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE NO",
"identifier": "20395",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albany, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.