Jennifer Walters, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA866 Issued in KY

Practice address

4201 Springhurst Blvd Ste 102
Louisville, KY 40241-6156

Phone

(025) 156-0905

Fax

(502) 883-0016

NPI assigned

Dec 14, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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, 2000

Medicare assignment

May accept Medicare assignment

Group practices

Restorative Pain InstituteGroup PAC ID 7113373176, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jennifer.walters.1@32492.direct.athenahealth.com

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.

• Restorative Pain Institute

  • Interventional Pain Medicine Physician
  • Louisville, KY
  • NPI 1871275792
  Medicare reassignment Care Compare group
• Restorative Pain Institute

  • Nurse Practitioner
  • Louisville, KY
  • NPI 1174322309
  NPD
• Restorative Pain Institute

  • Physician Assistant
  • Louisville, KY
  • NPI 1245021369
  NPD
• University Medical Associates

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1417902925
  NPD (past)

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1376528216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 SPRINGHURST BLVD STE 102",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402416156",
            "telephone_number": "025-156-0905",
            "fax_number": "502-883-0016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 SPRINGHURST BLVD STE 102",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402416156",
            "telephone_number": "025-156-0905",
            "fax_number": "502-883-0016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "JENNIFER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-14",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95004818",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Henry J Walter, MD
• Brian Richard Walters, CRNA
• Brittany Walters
• Chadwick A Walters, DO
• Cristine Walters, MS, CCC-SLP
• Nathan Frederick Walters, DMD
• Anna Walton, LCSW
• Camille Juliet Walton
• Carol Walton, LCSW
• Charlee McKynna Walton

• Physician Assistant in Louisville, KY
• Providers in Louisville, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; 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.