KEITH NESTA WALTERS – Internal Medicine Physician, NPI 1174264907

KEITH NESTA WALTERS is a healthcare provider. based in Athens, Georgia. specializing in INTERNAL MEDICINE. They hold a License No. 13706 (GA). The NPI Number for KEITH NESTA WALTERS is 1174264907

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
KEITH NESTA WALTERS
NPI
1174264907
Phone
(706) 389-3860
Address
1230 BAXTER ST
Enumeration Date
5 April 2022
Last Update Date
20 October 2025

Doctor Profile

Medical School Name
MEHARRY MEDICAL COLLEGE SCHOOL OF MEDICINE
Secondary Phone
7702092787
Graduation Year
2022 (4 years ago)
PAC ID
5092196774
Group Practice PAC ID
1557761087
Professional Enrollment ID
I20251007000473
Address ID
GA305192600BU2129XRDXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness85
Years active:4State licenses:1Digital endpointsOther names

5,425 INTERNAL MEDICINE in GA

Provider Addresses for KEITH NESTA WALTERS

  • 1230 BAXTER ST

    ATHENS, GA 306063712

    Phone: (706) 389-3860

    Type: Mailing

  • 1500 OGLETHORPE AVE STE 200D

    ATHENS, GA 306062165

    Phone: (706) 389-3875

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $40.

Total Amount is formed as General ($40) + Research ($0) + Ownership ($0) = $40.

Last reported payment date: 2024-11-07 • Largest payer in this snapshot: Xeris Pharmaceuticals, Inc. ($22).

Total Amount

$40

General + Research + Ownership

Payments

2

Total payment records

General Amount

$40

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-07

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-10-07

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20251007000473IInternal MedicineGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30606)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1557761087View full group profile
NameSpecialtyState
Emergency Medicine, Family PracticeGA
Family PracticeGA
Emergency Medicine, Family PracticeGA
Emergency Medicine, Family PracticeMN
Family Practice, Emergency MedicineGA

Reviews

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Frequently asked questions

What is the 10-digit NPI for KEITH NESTA WALTERS?
KEITH NESTA WALTERS — NPI 1174264907 — is the standard way to identify this listing.
Is KEITH NESTA WALTERS still practicing?
KEITH NESTA WALTERS is currently listed as active in the public NPI registry.
What taxonomy line describes KEITH NESTA WALTERS?
For research purposes, treat KEITH NESTA WALTERS as Internal Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
What area does KEITH NESTA WALTERS serve?
KEITH NESTA WALTERS's listing highlights Athens, Georgia; more addresses can appear in NPPES.
Is the information about KEITH NESTA WALTERS up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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