Individual provider Active NPI

Perry James Walton, D.O.

  • Emergency Medicine Physician
  • Pascagoula, MS
National Provider Identifier
1831210608
Registry record updated Sep 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
22667 Issued in MS
Practice address
2809 Denny Ave
Pascagoula, MS 39581
Phone
(228) 809-5000
Fax
(228) 809-5000
NPI assigned
Apr 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 22667 MS Primary

Addresses

Primary practice location

2809 Denny Ave
Pascagoula, MS 39581

Mailing address

PO Box 746368
Atlanta, GA 30374-6368
Phone (855) 691-9890

Other practice location 1

222 W Ray Ave
High Point, NC 27262-3914
Phone (336) 878-6000 ext. 2484

Other identifiers 3

IdentifierTypeStateIssuer
466877061BMedicaidGA
09683095MedicaidMS
GA1067MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20240223003012 MS Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 5991857369

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5307TNMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Au Medical Associates Inc Current Accepting new patients
Regional Emergency Physicians PA Emergency Medicine Past Accepting new patients
Csra Emergency Physicians Emergency Medicine Past Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

2260 Wrightsboro Rd
Augusta, GA 30904
Phone (706) 481-7000

Interoperability endpoints

  • Direct secure messaging: pwalton@landmarkhealth-direct.org

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": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1831210608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746368",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746368",
            "telephone_number": "855-691-9890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2809 DENNY AVE",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "39581",
            "telephone_number": "228-809-5000",
            "fax_number": "228-809-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 W Ray Ave",
            "address_purpose": "LOCATION",
            "city": "High Point",
            "state": "NC",
            "postal_code": "272623914",
            "country_code": "US",
            "telephone_number": "336-878-6000 x2484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALTON",
        "first_name": "PERRY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "22667",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "466877061B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09683095",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GA1067",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pascagoula, MS

Sources for this page

Verify at the official NPI Registry.