Active NPI
Michelle Waltz Brown, PPCNP-BC
- Pediatric Nurse Practitioner
- Jacksonville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- APRN11012933
- Practice address
- 841 Prudential Dr Ste 280
Jacksonville, FL 32207-8350 - Phone
- (904) 202-8550
- Fax
- (904) 393-7808
- NPI assigned
- Aug 22, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | APRN11012933 | FL | Primary |
Addresses
Primary practice location
841 Prudential Dr Ste 280
Jacksonville, FL 32207-8350
Mailing address
10140 Centurion Pkwy N
Jacksonville, FL 32256-0532
Phone (904) 697-4100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194005199 | Medicaid | VA | |
| 7005620 | Medicaid | NC |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baptist Specialty Physicians Inc | Current | Accepting new patients | |
| Baptist Specialty Physicians Inc | Current | Accepting new patients | |
| University of Florida Jacksonville Physicians, Inc. | Current | Accepting new patients | |
| University of Florida Jacksonville Physicians, Inc. | Current | Accepting new patients | |
| The Nemours Foundation | Past | Accepting new patients | |
| Children's Surgical Specialty Group, Inc | Past | Accepting new patients |
Locations
1443 San Marco Blvd
Jacksonville, FL 32207
Phone (904) 633-4110
841 Prudential Dr
Ste 280
Jacksonville, FL 32207
Phone (904) 202-8290
841 Prudential Dr
Ste 100
Jacksonville, FL 32207
Phone (904) 633-4110
841 Prudential Dr
Ste 1900
Jacksonville, FL 32207
Phone (904) 427-8453
1747 Baptist Clay Dr
Orange Park, FL 32003
Phone (904) 202-8550
2418 E Plaza Dr
Tallahassee, FL 32308
Phone (850) 629-4861
Interoperability endpoints
- mbrown156865@direct.nemours.org
Organizations & group practices 6
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.
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Jacksonville, FL
- NPI 1407226228
-
- Internal Medicine Physician
- Jacksonville, FL
- NPI 1144276452
-
dba Wolfson Children's Specialty Services
- Pediatric Cardiology Physician
- Jacksonville, FL
- NPI 1184392847
-
dba UF Health Imaging Center-Baymeadows
- Physiological Laboratory
- Jacksonville, FL
- NPI 1831800952
-
- Multi-Specialty Clinic/Center
- Jacksonville, FL
- NPI 1265585806
-
- Pediatric Surgery Physician
- Norfolk, VA
- NPI 1245248947
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761782400000",
"number": "1194005199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10140 CENTURION PKWY N",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322560532",
"telephone_number": "904-697-4100",
"fax_number": "904-697-5102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "841 PRUDENTIAL DR STE 280",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322078350",
"telephone_number": "904-202-8550",
"fax_number": "904-393-7808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROWN",
"first_name": "MICHELLE",
"middle_name": "WALTZ",
"credential": "PPCNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-22",
"last_updated": "2025-10-30",
"certification_date": "2025-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "FL",
"license": "APRN11012933",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1194005199",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7005620",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.