MR. RON SHANNON WALTERS – Certified Registered Nurse Anesthetist, NPI 1669141172

MR. RON SHANNON WALTERS is a healthcare provider. based in Griffin, Georgia. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold a License No. RN223340 (GA). The NPI Number for MR. RON SHANNON WALTERS is 1669141172

Main info

Male
5 Years Of Experience
Accepts Medicare Assignment
Name
MR. RON SHANNON WALTERS
NPI
1669141172
Phone
(404) 425-8409
Address
1123 MAPLE DR
Enumeration Date
8 September 2021
Last Update Date
13 February 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7702282721
Graduation Year
2021 (5 years ago)
PAC ID
8820464654
Group Practice PAC ID
9436372323
Professional Enrollment ID
I20221020000036
Address ID
GA302244213GR601XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:4State licenses:2Digital endpointsOther names

1,710 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in GA

Provider Addresses for MR. RON SHANNON WALTERS

  • 1123 MAPLE DR

    GRIFFIN, GA 302244938

    Phone: (404) 425-8409

    Type: Mailing

  • 601 S 8TH ST

    GRIFFIN, GA 302244213

    Phone: (770) 228-2721

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $13.

Total Amount is formed as General ($13) + Research ($0) + Ownership ($0) = $13.

Last reported payment date: 2023-05-24 • Largest payer in this snapshot: Glaukos Corporation ($13).

Total Amount

$13

General + Research + Ownership

Payments

1

Total payment records

General Amount

$13

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-05-24

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Glaukos Corporation$13
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: 2022-10-20

PECOS data refreshed: 2026-05-27

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
I20221020000036ICertified Registered Nurse Anesthetist (Crna)GATBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
00142Anesthesia for lens surgery166151$0
00140Anesthesia for other procedure on eye5145$0
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope2321$0
00811Anesthesia for other procedure on large bowel using an endoscope1413$0
View full utilization report →

Insurance plans in this area (ZIP 30224)

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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: 9436372323View full group profile
NameSpecialtyState
Anesthesiology, Pain ManagementGA
-GA
Certified Registered Nurse Anesthetist (Crna)GA
-GA
Pain Management, AnesthesiologyGA
Certified Registered Nurse Anesthetist (Crna)GA
Certified Registered Nurse Anesthetist (Crna)FL
Certified Registered Nurse Anesthetist (Crna)GA
Certified Registered Nurse Anesthetist (Crna)GA
Certified Registered Nurse Anesthetist (Crna)MI

Reviews

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Frequently asked questions

Does MR. RON SHANNON WALTERS share an NPI with anyone else?
NPI numbers are unique to each provider or organization — MR. RON SHANNON WALTERS uses 1669141172.
Does the file indicate MR. RON SHANNON WALTERS is practicing under active NPI?
Directory data currently reports MR. RON SHANNON WALTERS as active.
What is MR. RON SHANNON WALTERS's primary classification?
Certified Registered Nurse Anesthetist is the headline specialty for MR. RON SHANNON WALTERS here. Clinical services aligned with this taxonomy classification.
Where is MR. RON SHANNON WALTERS based?
MR. RON SHANNON WALTERS is tied to Griffin, Georgia in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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