Individual provider Active NPI

Erica Waters, APRN

  • Nurse Practitioner
  • Orange Park, FL
National Provider Identifier
1033797642
Registry record updated Sep 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11012485 Issued in FL
Practice address
1279 Kingsley Ave Ste 102
Orange Park, FL 32073-4657
Phone
(904) 604-9914
Fax
(629) 600-6769
NPI assigned
Apr 2, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11012485 FL Primary

Addresses

Primary practice location

1279 Kingsley Ave Ste 102
Orange Park, FL 32073-4657

Mailing address

1279 Kingsley Ave Ste 102
Orange Park, FL 32073-4657
Phone (904) 604-9914

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20210929000693 FL Practitioner - Nurse Practitioner 8325445661 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiorenal Therapeutics LLCGroup PAC ID 7416280425, 34 clinicians

Practice addresses (Care Compare)

6817 Southpoint Pkwy
Suite 203
Jacksonville, FL 32216-6286
Phone (904) 330-1024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11012485FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiac Vision LLC CurrentSince Jun 26, 2021 Accepting new patients
Cardiorenal Therapeutics LLC CurrentSince Jan 1, 2025 Accepting new patients
Birth and Beyond PastSince Apr 1, 2021 Accepting new patients

Locations

6817 Southpoint Pkwy
Ste 203
Jacksonville, FL 32216
Phone (904) 256-9202

7807 Baymeadows Rd E
Ste 209
Jacksonville, FL 32256
Phone (904) 231-1204

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1033797642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1279 KINGSLEY AVE STE 102",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734657",
            "telephone_number": "904-604-9914",
            "fax_number": "629-600-6769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1279 KINGSLEY AVE STE 102",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734657",
            "telephone_number": "904-604-9914",
            "fax_number": "629-600-6769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "ERICA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-02",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11012485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.