Organization Active NPI

Scot a. Wall, MD, PC

  • Ophthalmology Physician
  • Albany, GA
National Provider Identifier
1922007525
Registry record updated Mar 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
SCOT A. WALL, MD, PC
Practice address
2308 Palmyra Rd
Albany, GA 31701-1324
Phone
(229) 888-2395
NPI assigned
Jul 18, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2008

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

Authorized official

Name
Dr. Scot Allen Wall, MDNPI 1760487276
Title
Owner/President
Phone
(229) 888-2395

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

2308 Palmyra Rd
Albany, GA 31701-1324

Mailing address

2308 Palmyra Rd
Albany, GA 31701-1324
Phone (229) 888-2395

Other identifiers 1

IdentifierTypeStateIssuer
55000513AMedicaidGA

Other names 1

  • Wall Eye Care Associates Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204502400000",
    "number": "1922007525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2308 PALMYRA RD",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011324",
            "telephone_number": "229-888-2395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2308 PALMYRA RD",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011324",
            "telephone_number": "229-888-2395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOT A. WALL, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-18",
        "last_updated": "2008-03-03",
        "status": "A",
        "authorized_official_last_name": "WALL",
        "authorized_official_first_name": "SCOT",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "229-888-2395",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "55000513A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wall Eye Care Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.