WALTER KENNETH AUSTIN MD NPI 1548265838

NPI Information

NPI: 1548265838
Provider Name: WALTER KENNETH AUSTIN, MD
Classification: Clinic/Center - 261QF0400X
Specialization: Federally Qualified Health Center (FQHC)
Entity Type: Individual
PECOS Registration: Yes
Address: 175 SAMARITAN DR
JASPER, GA
ZIP 30143
Phone: (706) 253-4633

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NPI Details

Walter Kenneth Austin, MD is a federally qualified health center (fqhc) clinic center in Jasper, GA. Walter Kenneth Austin, MD NPI is 1548265838. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

175 SAMARITAN DR
JASPER, GA
ZIP 30143-964
Phone: (706) 253-4633
Fax: (706) 253-1192

The NPI 1548265838 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/14/2005 and was last updated on 9/4/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0000X	Internal Medicine	Cardiovascular Disease	047049	GEORGIA	No
2	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	047049	GEORGIA	Yes
3	207R00000X	Internal Medicine		047049	GEORGIA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000818639DEG	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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