DR. GORDON LESLIE WALTERS (NPI# 1255313789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255313789 |
| Entity Type | Individual |
| Full Name | DR. GORDON LESLIE WALTERS |
| Credential | MD |
| Practice Address |
818 Saint Sebastian Way Suite 311 Augusta GA 30901-2651 |
| Mailing Address |
Po Box 925 Augusta GA 30903-0925 |
| Practice Telephone | 7067243473 |
| Practice Fax Number | 7067243493 |
| Mailing Telephone | 7067243473 |
| Mailing Fax Number | 7067243493 |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2020-06-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
030919 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000385602A | 05 | |
| SC | G30919 | 05 | |
| GA | BCBS | 024281 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1348 Walton Way Ste 5100, Augusta, GA 309015108 | 7067248611 | 7067248611 |
| Street Address |
818 SAINT SEBASTIAN WAY SUITE 311 |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30901-2651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083612352 | Randy Wilson Cooper | Surgery | 818 Saint Sebastian Way, Suite 408, Augusta, GA 30901-2651 | 2005-07-12 |
| 1144697194 | Debora Sumner Mulling | Nurse Practitioner | 818 Saint Sebastian Way, Suite 308, Augusta, GA 30901-2651 | 2015-08-25 |
| 1427483155 | Erin Timmerman Cooper | Nurse Practitioner | 818 Saint Sebastian Way, Suite 307, Augusta, GA 30901 | 2013-09-12 |
| 1588902613 | Matthew K Howard, Md, LLC | Internal Medicine | 818 Saint Sebastian Way, Suite 311, Augusta, GA 30901-2651 | 2013-01-24 |
| 1760735401 | Toni Lynn Davis | Physician Assistant | 818 Saint Sebastian Way, Suite 311, Augusta, GA 30901-2651 | 2012-10-18 |
| 1104051754 | University Vascular Specialist, Inc. | Surgery | 818 Saint Sebastian Way, Suite 408, Augusta, GA 30901-2651 | 2009-05-27 |
| 1750515672 | Neighborhood Improvement Project Inc. | Legal Medicine | 818 Saint Sebastian Way, Suite 404a, Augusta, GA 30901-2651 | 2009-05-06 |
| 1407011802 | Santosh C Varkey | Internal Medicine | 818 Saint Sebastian Way, Suite 311, Augusta, GA 30901-2651 | 2008-07-24 |
| 1164685343 | University Sleep Associates | Specialist | 818 Saint Sebastian Way, Suite 101, Augusta, GA 30901-2651 | 2008-07-08 |
| 1235301771 | Brandi Nicole Pettis | Audiologist | 818 Saint Sebastian Way, Suite 204, Augusta, GA 30901-2651 | 2008-03-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477019925 | Courtney Erin Fairchild | Physician Assistant | 1101 15th Street, Pa-224, Augusta, GA 30901 | 2019-02-20 |
| 1699263921 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1022 Walton Way Spc C, Augusta, GA 30901 | 2018-04-23 |
| 1235684192 | Heather Raborn | Allergy & Immunology | 1350 Walton Way Ste 5100, Augusta, GA 30901 | 2016-08-22 |
| 1457690745 | Rehab Without Walls, Inc. | In Home Supportive Care | 820 St Sebastin Way Se, Augusta, GA 30901 | 2013-02-06 |
| 1861788051 | Christina Weidner Belcher | Physical Therapist | 1246 Pine St, Augusta, GA 30901 | 2011-06-25 |
| 1750695979 | C H Martin Company | Durable Medical Equipment & Medical Supplies | 1456 Walton Way Suite B, Augusta, GA 30901 | 2010-07-29 |
| 1366773905 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4027 Wheeler Rd, Augusta, GA 30901 | 2010-01-21 |
| 1851622484 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1715 Forest Drive, Augusta, GA 30901 | 2010-01-21 |
| 1760615280 | Absolute Family PCh | Point of Service | 2035 Old Savannah Rd., Augusta, GA 30901 | 2009-09-01 |
| 1073740643 | Ryan J Altenburg | Internal Medicine | 820 Saint Sebastian Way Ste 8a, Augusta, GA 30901 | 2009-06-22 |
| Find all providers in zip 30901 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568894087 | Umg Vascular, LLC | Internal Medicine | 1350 Walton Way, Augusta, GA 30901-2612 | 2013-08-07 |
| 1316239346 | University Cardiology Associates LLC | Internal Medicine | 818 Saint Sebastian Way Ste 311, Augusta, GA 30901-2653 | 2011-05-10 |
| 1699067629 | University Cardiology Associates LLC | Internal Medicine | 1348 Walton Way Ste 5100, Augusta, GA 30901 | 2011-05-10 |
| 1902198369 | University Cardiology Associates LLC | Internal Medicine | 818 Saint Sebastian Way Ste 308, Augusta, GA 30901-2653 | 2011-05-04 |
| 1538371802 | Vishal Arora | Internal Medicine | 1120 15th St, Augusta, GA 30912-0004 | 2007-05-07 |
| 1871603134 | Deepak Kapoor | Internal Medicine | 1120 15th St, Augusta, GA 30912-0004 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669019394 | Champ Vascular, LLC | Internal Medicine | 1825 Highway 34 E Ste 3400, Newnan, GA 30265-6423 | 2019-12-02 |
| 1174006159 | Kendall M Griffith Md LLC | Internal Medicine | 1497 Fair Rd Ste 311, Statesboro, GA 30458-0828 | 2018-09-14 |
| 1558869826 | Coordinated Health of Ga, LLC | Internal Medicine | 10 Glenlake Pkwy Ste 130c, Atlanta, GA 30328-3495 | 2018-01-31 |
| 1447559604 | David Brendan Casey | Internal Medicine | 1700 Tree Ln Ste 100, Snellville, GA 30078-6749 | 2011-03-26 |
| 1730404120 | Deepali Nivas Tukaye | Internal Medicine | 1505 Northside Blvd Ste 3400, Cumming, GA 30041-8223 | 2010-03-29 |
| 1659560647 | Oduwole Organization Inc | Internal Medicine | 1415 Highway 85 N Ste 310-296, Fayetteville, GA 30214-7738 | 2007-10-16 |
| 1053487462 | Tiftarea Cardiology | Internal Medicine | 907 E. 18th St, Ste 100, Tifton, GA 31794 | 2006-11-28 |
| 1255412094 | Jeetendra B Patel | Internal Medicine | 1301 Sigman Rd Ne Ste 200, Conyers, GA 30012 | 2006-10-18 |
| 1811082605 | Cardiac Disease Specialists, PC | Internal Medicine | 296 Merchants Sq, Dallas, GA 30132-5029 | 2006-10-04 |
| 1770508756 | Hunt Dandridge Anderson | Internal Medicine | 4500 Hospital Blvd, Suite 230, Roswell, GA 30076-0003 | 2006-07-12 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.