Jessica D Waller, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

RN216597 Issued in GA

Practice address

2470 Daniells Bridge Rd Ste 251
Athens, GA 30606-6192

Phone

(706) 389-3440

Fax

(706) 353-2205

NPI assigned

Mar 27, 2021

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in GA

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

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. Mary's Medical Group, Inc.Group PAC ID 7113098393, 118 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/7598/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir4.healow.com/fhir/r4/DJCADA
• Direct secure messaging: jwaller2680517@direct.trinity-health.org

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

• St Mary's Medical Group, Inc

  • Cardiovascular Disease Physician
  • Athens, GA
  • NPI 1376711333
  Medicare reassignment Care Compare group NPD
• St. Mary's Medical Group, Inc.

  • Anatomic Pathology & Clinical Pathology Physician
  • Athens, GA
  • NPI 1316733355
  NPD
• Georgia Renal Associates, PC

  • Nephrology Physician
  • Athens, GA
  • NPI 1780851436
  NPD (past)

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

{
    "created_epoch": "1616803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1346827094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 48089",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306048089",
            "telephone_number": "706-389-3740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2470 DANIELLS BRIDGE RD STE 251",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306066192",
            "telephone_number": "706-389-3440",
            "fax_number": "706-353-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "JESSICA",
        "middle_name": "D",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-27",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN216597",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwaller2680517@direct.trinity-health.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2470 Daniells Bridge Rd Ste 251",
            "city": "Athens",
            "state": "GA",
            "country_code": "US",
            "postal_code": "306066192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kelly E. Wall, ANP-BC
• Ansley Wallace
• Rex Michael Wallace, NP
• Stephanie R Wallace, NP
• Esther Wimlen Wallach, M.D., M.SC.
• Valerie D Waller
• Barbette Walls, RN
• Laine Catharine Walls
• Rebecca Walls, CCC-SLP
• Sheri Patrice Walls, MD

• Adult Health Nurse Practitioner in Athens, GA
• Providers in Athens, GA by specialty
• Adult Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; 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.