Individual provider Active NPI

Christopher James Walsh, P.A.-C

  • Medical Physician Assistant
  • Atlanta, GA
National Provider Identifier
1720103161
Registry record updated Nov 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
003974 Issued in GA
Practice address
95 Collier Road NW
Suite 2035
Atlanta, GA 30309
Phone
(404) 605-2800
Fax
(404) 351-5983
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 003974 GA Primary

Addresses

Primary practice location

95 Collier Road NW
Suite 2035
Atlanta, GA 30309

Mailing address

95 Collier Road NW
Suite 2035
Atlanta, GA 30309
Phone (404) 605-2800

Other identifiers 1

IdentifierTypeStateIssuer
370650073A,BMedicaidGA

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
I20050201000547 GA Practitioner - Physician Assistant 2466403084 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
003974GAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Josephs Hospital of Atlanta Inc CurrentSince Jan 1, 2005 Accepting new patients

Locations

5667 Ptree Dunwoody Rd NE
Sandy Springs, GA 30342
Phone (404) 851-5100

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290384000000",
    "number": "1720103161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 COLLIER ROAD NW",
            "address_2": "SUITE 2035",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30309",
            "telephone_number": "404-605-2800",
            "fax_number": "404-351-5983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 COLLIER ROAD NW",
            "address_2": "SUITE 2035",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30309",
            "telephone_number": "404-605-2800",
            "fax_number": "404-351-5983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "CHRISTOPHER",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2010-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "003974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370650073A,B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.