Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Richard Alan Wall II

Individual provider Nurse Practitioner · NPI 1134093099

Richard Alan Wall II is a Nurse Practitioner in Macon, Georgia. Qualified in 2025, 1 year ago. Practices with Cogent Healthcare of Georgia PC, a 255-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
1
Licensed in
GA
In the registry since
2025
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Practice location Address checks out

350 Hospital Dr Ste 230
Macon, GA 31217-3838
Phone: (478) 751-0332
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence RN314437 (GA)

Record details

NPI number1134093099
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 2, 2025
Last updated in NPPESOctober 2, 2025
Certification dateOctober 2, 2025
Mailing address199 Tidwell Rd, Bonaire, GA 31005-4172

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Cogent Healthcare Of Georgia Pc — 255 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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