Marie Louise Walton, MD, MPH

Primary specialty

Research Clinic/CenterTaxonomy code 261QR1100X

License

47677 Issued in GA

Practice address

113 Upper Riverdale Rd SW
Riverdale, GA 30274-2540

Phone

(678) 430-3232

Fax

(678) 321-0022

NPI assigned

Jun 11, 2019

Last updated

May 11, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Marie Louise Pehna Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1962061226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3352 GLEN DEVON LN",
            "city": "BERKELEY LAKE",
            "state": "GA",
            "postal_code": "300966195",
            "telephone_number": "404-642-7721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 UPPER RIVERDALE RD SW",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742540",
            "telephone_number": "678-430-3232",
            "fax_number": "678-321-0022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Johnson Ferry Rd Ste 420",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303421743",
            "country_code": "US",
            "telephone_number": "404-851-9934",
            "fax_number": "404-851-9458",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "WINDWARD MEDICAL CLINIC",
            "address_2": "4080 McGINNIS FERRY RD BLDG 400 STE 402",
            "address_purpose": "LOCATION",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "30005",
            "country_code": "US",
            "telephone_number": "678-677-0434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALTON",
        "first_name": "MARIE",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-11",
        "last_updated": "2021-05-11",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QR1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Research",
            "state": "GA",
            "license": "47677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "ERT",
            "affiliation": "N",
            "address_1": "113 Upper Riverdale Rd SW",
            "city": "Riverdale",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302742540",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "ERT",
            "affiliation": "N",
            "address_1": "1100 Johnson Ferry Rd Ste 420",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303421743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARIE",
            "last_name": "PEHNA",
            "middle_name": "LOUISE",
            "prefix": "DR.",
            "credential": "MD, MPH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Research Clinic/Center in Riverdale, GA
• Providers in Riverdale, GA by specialty
• Research Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; 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.