Individual provider Active NPI

Gary Richard Walton, MD

  • Urology Physician
  • Watkinsville, GA
National Provider Identifier
1902804784
Registry record updated Jun 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
036630 Issued in GA
Practice address
1150 Golden Way
Watkinsville, GA 30677-7712
Phone
(706) 612-9401
Fax
(706) 612-9420
NPI assigned
Jul 14, 2005
Last updated
Jun 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 036630 GA Primary

Addresses

Primary practice location

1150 Golden Way
Watkinsville, GA 30677-7712

Mailing address

1150 Golden Way
Watkinsville, GA 30677-7712
Phone (706) 612-9401

Other practice location 1

1740 Lions Club Rd Ste 200
Madison, GA 30650-4762
Phone (706) 612-9401

Other practice location 2

644 N Chase St Ste 105
Athens, GA 30601-1960
Phone (706) 612-9401

Other identifiers 2

IdentifierTypeStateIssuer
000532188EMedicaidGA
000532188IMedicaidGA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110112000600 GA Practitioner - Urology 8628267267 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Emory University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athens Area Urology PCGroup PAC ID 0446491641, 18 clinicians

Practice addresses (Care Compare)

1150 Golden Way
Watkinsville, GA 30677-7712
Phone (706) 612-9401

1740 Lions Club Rd
Suite 200
Madison, GA 30650-4762
Phone (706) 612-9401

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.9 of 100Reported as group
Promoting interoperability
94
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036630GAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Athens Area Urology, PC Urology CurrentSince Jun 1, 2013 Accepting new patients

Locations

2142 W Broad St
Bldg 200
Athens, GA 30606
Phone (706) 548-6881

644 N Chase St
Ste 105
Athens, GA 30601

1740 Lions Club Rd
Ste 200
Madison, GA 30650
Phone (706) 342-3553

1150 Golden Way
Watkinsville, GA 30677
Phone 8888180563300

Interoperability endpoints

  • Direct secure messaging: gary.walton@ewb-urology.gadirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1902804784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 GOLDEN WAY",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306777712",
            "telephone_number": "706-612-9401",
            "fax_number": "706-612-9420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 GOLDEN WAY",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306777712",
            "telephone_number": "706-612-9401",
            "fax_number": "706-612-9420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1740 Lions Club Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "GA",
            "postal_code": "306504762",
            "country_code": "US",
            "telephone_number": "706-612-9401",
            "fax_number": "706-612-9420",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "644 N Chase St Ste 105",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306011960",
            "country_code": "US",
            "telephone_number": "706-612-9401",
            "fax_number": "706-612-9420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALTON",
        "first_name": "GARY",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "036630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000532188E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000532188I",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watkinsville, GA

Sources for this page

Verify at the official NPI Registry.