Individual provider Active NPI

Walker Reid Nugent

  • Registered Nurse
  • Douglas, GA
National Provider Identifier
1962231555
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN294968 Issued in GA
Practice address
564 Pine Needle Rd
Douglas, GA 31535-6526
Phone
(912) 592-5354
NPI assigned
Jul 31, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN294968 GA Primary

Addresses

Primary practice location

564 Pine Needle Rd
Douglas, GA 31535-6526

Mailing address

564 Pine Needle Rd
Douglas, GA 31535-6526
Phone (912) 592-5354

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251113003820 GA Practitioner - Certified Registered Nurse Anesthetist (Crna) 0143711580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tift Regional Health System IncGroup PAC ID 2062745169, 294 clinicians

Practice addresses (Care Compare)

2225 US Hwy 41 N
Tifton, GA 31794-2749
Phone (229) 391-4100

2227 US Hwy 41 N
Tifton, GA 31794-2749
Phone (229) 353-6188

901 18TH St E
Tifton, GA 31794-3648
Phone (229) 382-7120

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN294968GAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Tift Regional Health System Inc CurrentSince Nov 1, 2025 Accepting new patients
Tift Regional Health System Inc Current Accepting new patients
Tift Regional Health System Inc. CurrentSince Nov 1, 2025 Accepting new patients

Locations

2227 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-6188

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.

Hospital & facility affiliations 1

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": "1722384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1962231555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "564 PINE NEEDLE RD",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315356526",
            "telephone_number": "912-592-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "564 PINE NEEDLE RD",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315356526",
            "telephone_number": "912-592-5354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUGENT",
        "first_name": "WALKER",
        "middle_name": "REID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-31",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN294968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglas, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.