Organization Active NPI

Walter F. Anderson, MD, PC

  • Psychiatry Physician
  • Atlanta, GA
National Provider Identifier
1972833564
Registry record updated Jan 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
021939 Issued in GA
Legal business name
WALTER F. ANDERSON, MD, PC
Practice address
4675 N Shallowford Rd
Suite 210
Atlanta, GA 30338-6309
Phone
(770) 936-9403
Fax
(770) 936-9474
NPI assigned
Jan 5, 2010
Last updated
Jan 5, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2010

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

Authorized official

Name
Dr. Walter Faust Anderson, MDNPI 1629194907
Title
President
Phone
(770) 936-9403

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 021939 GA Primary

Addresses

Primary practice location

4675 N Shallowford Rd
Suite 210
Atlanta, GA 30338-6309

Mailing address

4675 N Shallowford Rd
Suite 210
Atlanta, GA 30338-6309
Phone (770) 936-9403

National Provider Directory

National Provider Directory

Locations

4675 N Shallowford Rd
Ste 210
Atlanta, GA 30338
Phone (770) 936-9403

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1262649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262649600000",
    "number": "1972833564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4675 N SHALLOWFORD RD",
            "address_2": "SUITE 210",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303386309",
            "telephone_number": "770-936-9403",
            "fax_number": "770-936-9474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4675 N SHALLOWFORD RD",
            "address_2": "SUITE 210",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303386309",
            "telephone_number": "770-936-9403",
            "fax_number": "770-936-9474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTER F. ANDERSON, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-05",
        "last_updated": "2010-01-05",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "FAUST",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-936-9403",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "021939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2010; 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.