KENNETH BRIAN WALTON (NPI# 1699719179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699719179 |
| Entity Type | Individual |
| Full Name | KENNETH BRIAN WALTON |
| Credential | MD |
| Practice Address |
1058 Bermuda Run Road Statesboro GA 30458-0858 |
| Practice Telephone | 9128717100 |
| Practice Fax Number | 9128717110 |
| Mailing Telephone | 9128717100 |
| Mailing Fax Number | 9128717110 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2020-09-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 065436 | GA | Allopathic & Osteopathic Physicians |
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 065436 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | AMERIGROUP | 014459259 | 01 |
| GA | RAILROAD MEDICARE | P01108293 | 01 |
| GA | 003107922A | 05 | |
| GA | BCBS | 52343669 | 01 |
| GA | WELLCARE | 626252 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942474200 | Kenneth Joseph Walton | Anesthesiology | 41 Mall Rd., Lahey Clinic, Burlington, MA 01805-0001 | 2008-04-17 |
| 1689783870 | Kenneth Glen Walton | Plastic Surgery | 1296 Sims St, Suite B, Gainesville, GA 30501-3850 | 2006-08-30 |
| Street Address |
1058 BERMUDA RUN ROAD |
| City | STATESBORO |
| State | GA |
| Zip Code | 30458-0858 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548420599 | Rebecca Marie Spahos | Surgery | 1058 Bermuda Run Road, Statesboro, GA 30458-0858 | 2008-06-12 |
| 1548448418 | Jean-claude David Schwartz | Surgery | 1058 Bermuda Run Road, Statesboro, GA 30458 | 2008-02-04 |
| 1104903814 | Camille Atallah | Specialist | 1058 Bermuda Run Road, Statesboro, GA 30458 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639642218 | Youtherapy | Counselor | 430 Northside Dr East, Suite 160 Mb326, Statesboro, GA 30458 | 2019-01-07 |
| 1053891853 | Alexandria Franklin | Specialist/Technologist | 1332 Southern Dr, Statesboro, GA 30458 | 2018-08-21 |
| 1740780006 | Michael Ryan Clark | Pharmacist | 556 Northside Drive, Statesboro, GA 30458 | 2018-02-13 |
| 1689186405 | Chandler James Herman | Specialist/Technologist | 590 Herty Dr., Statesboro, GA 30458 | 2017-11-02 |
| 1477009181 | Mama Doc Pediatrics, LLC | Pediatrics | 400 East Grady Street, Statesboro, GA 30458 | 2016-09-01 |
| 1053761171 | Rebekah Roessler | Specialist/Technologist | 2687 Akins Blvd, Statesboro, GA 30458 | 2016-06-20 |
| 1427412253 | Refocus Counseling and Consulting Services | Community/Behavioral Health | 4325 Country Club, 4, Statesboro, GA 30458 | 2016-04-07 |
| 1023408523 | Kacy H. Nesmith | Nurse Practitioner | 1098 Bermuda Run, Suite 6, Statesboro, GA 30458 | 2015-02-04 |
| 1760870398 | Jessica Pasternack | Specialist/Technologist | 2687 Akins Boulevard, Statesboro, GA 30458 | 2015-01-06 |
| 1922401629 | Nathan D'amico | Student in an Organized Health Care Education/Training Program | 15 W Grady Street Unit A, Statesboro, GA 30458 | 2014-10-08 |
| Find all providers in zip 30458 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437514239 | Tai Iwamura | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4410 Charleston Pl, Dunwoody, GA 30338-6463 | 2015-12-21 |
| 1821330663 | Michael Dory Horowitz | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3465 Harlan Dr Se, Smyrna, GA 30080-4617 | 2013-03-19 |
| 1295075703 | Holland Victor Moore | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 747 Aumond Rd, Augusta, GA 30909-3258 | 2013-02-20 |
| 1376894683 | Agewell Men's Institute | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3596 Old Milton Pkwy, Alpharetta, GA 30005-4465 | 2012-09-26 |
| 1376894709 | Chris Malone, Md | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 740 Prince Ave Ste 13, Athens, GA 30606-5906 | 2012-09-25 |
| 1356602056 | Andrew H Maloney | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 95 Collier Rd Nw Ste 2055, Atlanta, GA 30309-1721 | 2012-05-30 |
| 1134407075 | Robert A Hall Md LLC | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 10 Longfield Ct, Savannah, GA 31410-3513 | 2011-07-26 |
| 1912205964 | Umesh Nareppa | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1365 Clifton Rd Ne Ste A2228, Atlanta, GA 30322-1013 | 2011-02-28 |
| 1174754246 | Adil Sadiq | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1036 Carlyle Lk, Decatur, GA 30033-4632 | 2009-08-06 |
| 1760629216 | Jonathan Gerard Mcguiness | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1365a Clifton Road, Ne, Suite A2223 Cardiothoracic Surgery, Atlanta, GA 30322 | 2009-01-20 |
| Find all providers with the same taxonomy | ||||
| City | STATESBORO |
| Zip Code | 30458 |
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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.