Mr Ron Shannon Walters, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Griffin, Georgia. His current practice location is
601 S 8th St, Griffin, Georgia. You can reach out to his office (for appointments etc.) via phone at
(770) 228-2721.
Mr Ron Shannon Walters is licensed to practice in Georgia (license number RN223340) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1669141172.
Provider's Profile
| Full Name | Mr Ron Shannon Walters |
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| Gender | Male |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 601 S 8th St, Griffin, Georgia |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1669141172
- Provider Enumeration Date: 09/08/2021
- Last Update Date: 02/13/2023
Medicare PECOS Information:
- PECOS PAC ID: 8820464654
- Enrollment ID: I20221020000036
Medical Identifiers
Medical identifiers for Mr Ron Shannon Walters such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1669141172 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 367500000X | Nurse Anesthetist, Certified Registered | RN223340 (Georgia) | Primary |
| 163W00000X | Registered Nurse | 223340 (Georgia) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Ron Shannon Walters allows following entities to bill medicare on his behalf.
| Entity Name | Sentry Anesthesia Management, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1134544794
PECOS PAC ID: 9436372323
Enrollment ID: O20140521002571 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Ron Shannon Walters is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Ron Shannon Walters,
1123 Maple Dr,
Griffin, GA 30224-4938
Ph: (404) 425-8409 | Mr Ron Shannon Walters,
601 S 8th St,
Griffin, GA 30224-4213
Ph: (770) 228-2721 |
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