Active NPI
Dustin A Walsh, PA
- Physician Assistant
- Albany, GA
National Provider Identifier
1881774008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1473
- Practice address
- 804 13TH Ave
Albany, GA 31701-1328 - Phone
- (229) 438-5864
- Fax
- (229) 438-1004
- NPI assigned
- Oct 16, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1473 | GA | Primary |
Addresses
Primary practice location
804 13TH Ave
Albany, GA 31701-1328
Mailing address
194 Winifred Rd
Leesburg, GA 31763-4608
Phone (229) 869-5841
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1473 | GA | MD | Physical Therapist |
| 004960 | GA | MD | Community/Behavioral Health Agency |
| 003974 | GA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Albany Pulmonary and Critical Care, P.C. | Past | Accepting new patients | |
| Hospital Authority of the City of Bainbridge and Decatur County | Past | Accepting new patients | |
| Phoebe Physician Group, Inc | Past | Accepting new patients |
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.
-
- Internal Medicine Physician
- Albany, GA
- NPI 1356307102
-
- Multi-Specialty Clinic/Center
- Bainbridge, GA
- NPI 1053388256
-
- Clinic/Center
- Albany, GA
- NPI 1487899464
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294185600000",
"number": "1881774008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "194 WINIFRED RD",
"city": "LEESBURG",
"state": "GA",
"postal_code": "317634608",
"telephone_number": "229-869-5841"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "804 13TH AVE",
"city": "ALBANY",
"state": "GA",
"postal_code": "317011328",
"telephone_number": "229-438-5864",
"fax_number": "229-438-1004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALSH",
"first_name": "DUSTIN",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-16",
"last_updated": "2011-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "1473",
"primary": true
}
],
"identifiers": [],
"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 Jan 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.