KENNETH CHRISTIAN WALTERS (NPI# 1619005469) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619005469 |
| Entity Type | Individual |
| Full Name | KENNETH CHRISTIAN WALTERS |
| Credential | MD |
| Practice Address |
1120 15th St Augusta GA 30912-0004 |
| Mailing Address |
1499 Walton Way Suite 1400 Augusta GA 30901-2602 |
| Practice Telephone | 7067213941 |
| Mailing Telephone | 7067246100 |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2013-09-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 069664 | GA | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 128047 | NC | Allopathic & Osteopathic Physicians |
| Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
069664 | GA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134162365 | Kenneth S. Walters | Psychologist | 15 Farone Dr Apt B11, Oneonta, NY 13820-1337 | 2006-06-14 |
| 1366679458 | Kenneth Chet Walters | Internal Medicine | 2000 E Greenville St, Suite 1100, Anderson, SC 29621-1714 | 2009-06-16 |
| 1881878437 | Kenneth James Walters I | Physical Therapy Assistant | 300 Kildaire Woods Dr, Cary, NC 27511-5500 | 2007-12-19 |
| 1174658595 | Kenneth L Walters | Counselor | 660 Park St, Jacksonville, FL 32204-2933 | 2007-02-23 |
| Street Address |
1120 15TH ST |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30912-0004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427051556 | Gyanendra Kumar Sharma | Internal Medicine | 1120 15th St, Augusta, GA 30912-0004 | 2005-05-23 |
| 1912508532 | Lacey Nichol Preston | Physician Assistant | 1120 15th St, Augusta, GA 30912-0004 | 2020-11-02 |
| 1992302988 | Victoria Mae Pregibon | Physician Assistant | 1120 15th St, Augusta, GA 30912-0004 | 2020-10-03 |
| 1275130239 | Tanya Renee Hall | Nurse Practitioner | 1120 15th St, Augusta, GA 30912-0004 | 2020-10-02 |
| 1144847864 | Cassandra Marie Voong | Internal Medicine | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-29 |
| 1245857002 | Morgan Rowe | Nurse Practitioner | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-28 |
| 1639795990 | Lauren Christine Bush | Audiologist | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-23 |
| 1811513575 | Ashley Danielle Fox | Internal Medicine | 1120 15th St, Augusta, GA 30912-0006 | 2020-06-18 |
| 1265058994 | Matthew Craddock | Psychiatry & Neurology | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-18 |
| 1437775301 | Joseph John Arellano | Emergency Medicine | 1120 15th St, Augusta, GA 30912-0004 | 2020-06-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548885940 | Hannah Gullickson Folsom | Family Medicine | 1459 Laney Walker Blvd Ae 3042, Augusta, GA 30912 | 2020-06-11 |
| 1487278909 | Robert Kennedy | Internal Medicine | Augusta University Internal Medicine Residency Program, 1120 15th Street, Bi 5070, Augusta, GA 30912 | 2020-06-01 |
| 1952968737 | Kayla M. Lasota | Pediatrics | 11230 115th St Ae3042, Augusta, GA 30912 | 2019-05-28 |
| 1003379280 | Kayla Cox | Internal Medicine | 1120 15th St Bi5070, Augusta, GA 30912 | 2019-04-13 |
| 1619435740 | Justin Ray Mackert | Student in an Organized Health Care Education/Training Program | Augusta University, 1120 15th Street, Gc 5110, Augusta, GA 30912 | 2019-03-07 |
| 1417444167 | Victor Celis | Dentist | John Wesley Gilbert Dr, Augusta, GA 30912 | 2018-04-18 |
| 1487157921 | Julie Ann Matsen | Student in an Organized Health Care Education/Training Program | 997 St. Sebastian Way, Eg-2021-10, Augusta Univ., Dept. of Psychiatry & Health Behavior, Augusta, GA 30912 | 2018-03-12 |
| 1497287031 | Luke Yuung-jier Chang | Ophthalmology | 1120 15th St # Ba2720, Augusta, GA 30912 | 2017-04-02 |
| 1821537622 | Lashawn Kay Boone | Nurse Practitioner | 1445 Harper St, Augusta, GA 30912 | 2017-02-14 |
| 1134675564 | Arnab Saha | Internal Medicine | 1120 15 Th St., Augusta, GA 30912 | 2016-08-26 |
| Find all providers in zip 30912 | ||||
| Taxonomy Code | 2086S0120X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Pediatric Surgery |
| A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881794345 | Walter L. Pipkin | Surgery | 1120 15th St, Augusta, GA 30912-0004 | 2006-09-25 |
| 1881704161 | Charles G. Howell | Surgery | 1120 15th St, Augusta, GA 30912-0004 | 2006-08-30 |
| 1649380015 | Robyn M. Hatley | Surgery | 1120 15th St, Augusta, GA 30912-0004 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184948739 | Morgan Richards | Surgery | 1405 Clifton Rd Ne Dept Of, Atlanta, GA 30322 | 2010-03-24 |
| 1902083546 | Andrew P Bozeman | Surgery | 100 Medical Dr Ste 100, Dublin, GA 31021-2561 | 2008-01-25 |
| 1720278856 | Jonathan A Meisel | Surgery | 1400 Tullie Rd Ne Fl 1, Atlanta, GA 30329 | 2007-07-25 |
| 1326135591 | Kurt Frederick Heiss | Surgery | 1975 Century Center, Suite #6, Atlanta, GA 30345 | 2006-10-06 |
| 1528151859 | Amina Mira Bhatia | Surgery | 1975 Century Blvd Ne Ste 6, Atlanta, GA 30345-3316 | 2006-09-30 |
| 1760583710 | Megan Marie Durham | Surgery | 1975 Century Blvd Ne, Suite 6, Atlanta, GA 30345-3316 | 2006-09-25 |
| 1467451039 | Roger Mccoy Pitt | Surgery | 840 Pine St Ste 510, Macon, GA 31201-7530 | 2005-07-18 |
| 1790784221 | Theodore Brand | Surgery | 5248 Timber Ridge Rd, M, Marietta, GA 30068 | 2005-07-18 |
| 1366441941 | John Christopher Bleacher | Surgery | 5455 Meridian Marks Rd Ne, Suite 570, Atlanta, GA 30342-1654 | 2005-07-18 |
| 1558727289 | Cardiothoracic Providers At Childrens | Surgery | 1575 Northeast Expy Ne, Brookhaven, GA 30329-2401 | 2016-01-11 |
| Find all providers with the same taxonomy | ||||
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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.