Jordyn Riley Walter, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PT1322 Issued in WY

Practice address

508 Stocktrail Ave
Gillette, WY 82716-3582

Phone

(307) 686-1413

NPI assigned

Dec 9, 2024

Last updated

Dec 17, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Campbell County Hospital DistrictGroup PAC ID 2860392529, 128 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Campbell County Health Hospital, Gillette, WY, CCN 530002

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Campbell County Hospital District

  dba Campbell County Medical Group - Internal Medicine Clinic

  • Internal Medicine Physician
  • Gillette, WY
  • NPI 1710098868
  Medicare reassignment Care Compare group
• Campbell County Hospital District

  dba CCMH OBGYN Specialists

  • Obstetrics & Gynecology Physician
  • Gillette, WY
  • NPI 1740463520
  NPD
• Campbell County Hospital District

  dba Campbell County Health

  • Community/Retail Pharmacy
  • Gillette, WY
  • NPI 1992874218
  NPD
• Big Horn Health Network

  dba Sheridan Memorial Clinics

  • Internal Medicine Physician
  • Sheridan, WY
  • NPI 1861722688
  NPD (past)
• Campbell County Hospital District

  dba The Legacy Living & Rehabilitation Center

  • Skilled Nursing Facility
  • Gillette, WY
  • NPI 1376620989
  NPD (past)
• Powder River Orthopedics & Spine PC

  • Orthopaedic Surgery Physician
  • Gillette, WY
  • NPI 1356335533
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Campbell County Hospital District

  • General Acute Care Hospital
  • Gillette, WY
  • NPI 1487638417
  Care Compare affiliation
• Campbell County Hospital District

  dba Powder River Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Gillette, WY
  • NPI 1780738153

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1043026685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20557",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591040557",
            "telephone_number": "406-696-3412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 STOCKTRAIL AVE",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827163582",
            "telephone_number": "307-686-1413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTER",
        "first_name": "JORDYN",
        "middle_name": "RILEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-09",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WY",
            "license": "PT1322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores, Inc. (Vision Center 30-1485)
• Walgreen Co (Walgreens #07928)
• Walgreen Co. (Coalition Family Pharmacy)
• Susan P Walla, APRN
• Walmart Inc. (Walmart Pharmacy 10-1485)
• Kerry Elizabeth Warner, RN
• Tracy L Wasserburger, APRN
• Amy Darlene Weber, LPC
• Carene Emmett Weinand
• Wellhouse, LLC

• Physician Assistant in Gillette, WY
• Providers in Gillette, WY by specialty
• Physician Assistant in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.