WALTER SHANNON RAY (PAC) – Physician Assistant, NPI 1710081989

WALTER SHANNON RAY (PAC) is a healthcare provider. based in Douglas, Georgia. specializing in Physician Assistant. They hold the professional credentials PAC. They hold a License No. 003211 (GA). The NPI Number for WALTER SHANNON RAY (PAC) is 1710081989

Main info

Male
28 Years Of Experience
Accepts Medicare Assignment
Name
WALTER SHANNON RAY (PAC)
NPI
1710081989
Phone
(912) 383-9789
Address
100 DOCTORS DR
Enumeration Date
11 September 2006
Last Update Date
23 March 2010

Doctor Profile

Medical School Name
MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
1998 (28 years ago)
PAC ID
2961535109
Group Practice PAC ID
1355334509
Professional Enrollment ID
I20100809000580
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for WALTER SHANNON RAY (PAC)

  • Doctors Drive, Douglas, Coffee County, Georgia, 31534, United States

    STE 103

    DOUGLAS, GA 315332210

    Phone: (912) 383-9789

    Fax: (912) 383-9435

    Mailing address matches the actual address.

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: 2024-03-05 • Largest payer in this snapshot: Quidel Corporation ($23).

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

2024-03-05

Latest reported date

Top Companies

Largest payers in this snapshot

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

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

No Medicare enrollment or revalidation data available for this provider in our database.

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 31533)

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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: 1355334509View full group profile
NameSpecialtyState
-FL
Family PracticeGA
-GA
Family PracticeGA
-GA
Physician AssistantGA
-GA
-GA
Cardiac Surgery, Thoracic Surgery, Vascular SurgeryGA
Cardiovascular Disease (Cardiology), Interventional CardiologyIL

Reviews

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Frequently asked questions

Is WALTER SHANNON RAY (PAC) listed with a National Provider Identifier?
Yes — WALTER SHANNON RAY (PAC) has NPI 1710081989 on file in the registry.
Is WALTER SHANNON RAY (PAC) still an active registrant?
WALTER SHANNON RAY (PAC) carries an active NPI according to the public dataset.
What area of care is associated with WALTER SHANNON RAY (PAC)?
WALTER SHANNON RAY (PAC)'s record emphasizes Physician Assistant. Clinical services aligned with this taxonomy classification.
What locale is associated with WALTER SHANNON RAY (PAC)?
Directory geography for WALTER SHANNON RAY (PAC) centers on Douglas, Georgia.
Can I trust this NPI listing for WALTER SHANNON RAY (PAC)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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