Jillian Walters

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

907617 Issued in MS

Practice address

1391 Broad Ave
Gulfport, MS 39501-2419

Phone

(228) 863-8868

NPI assigned

Sep 23, 2025

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

Not listed in the public Medicare enrollment file

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.

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Memorial Hospital at Gulfport

  • General Acute Care Hospital
  • Gulfport, MS
  • NPI 1073606901
  NPD (past)

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

{
    "created_epoch": "1758585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781827200000",
    "number": "1376415851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 GIVENS DR",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395313277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1391 BROAD AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012419",
            "telephone_number": "228-863-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "JILLIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-23",
        "last_updated": "2026-06-19",
        "certification_date": "2026-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "907617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Walkington
• Allison Paulk Wall, M.D.
• Rachel Lacy Wall, LPC,M.ED
• Kayla Marie Walley
• Alvin Walsh III, NP-C
• Ted J Ward, R. PH.
• Alisha H. Ware, MD
• Paul Derek Ware, MD
• Gretchen Warkentien, CMHT
• Chelsie Warren

• Family Nurse Practitioner in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.