Individual provider Active NPI

Michelle Nichole Waters, ARNP

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1376091165
Registry record updated Apr 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9337907 Issued in FL
Practice address
2377 Dunn Ave
Jacksonville, FL 32218-6983
Phone
(904) 633-0700
NPI assigned
Sep 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9337907 FL Primary
Primary Care Nurse Practitioner 363LP2300X ARNP9337907 FL

Addresses

Primary practice location

2377 Dunn Ave
Jacksonville, FL 32218-6983

Mailing address

4567 Temple Lakes Dr
Jacksonville, FL 32257-7816
Phone (904) 894-8469

Other identifiers 1

IdentifierTypeStateIssuer
019282800MedicaidFL

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
I20161214002677 FL Practitioner - Nurse Practitioner 4082994728 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
59.59 of 100Reported as apm
Quality
59.93
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9337907FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians Inc CurrentSince May 2, 2024 Accepting new patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Nov 28, 2016 Accepting new patients
University of Florida Jacksonville Physicians Inc CurrentSince Nov 28, 2016 Accepting new patients
Virta Medical P.C. CurrentSince Sep 22, 2025 Accepting new patients

Locations

501 Folsom St
Fl 1
San Francisco, CA 94105

655 W 8th St
Jacksonville, FL 32209
Phone (904) 244-1680

1255 Lila St
Jacksonville, FL 32208
Phone (904) 244-5700

2377 Dunn Ave
Jacksonville, FL 32218
Phone (904) 633-0700

1201 Hays St
Fl 1
Tallahassee, FL 32301

625 E Twiggs St
Ste 110
Tampa, FL 33602
Phone (866) 603-7803

Interoperability endpoints

  • Direct secure messaging: mwaters62151@direct.shands.ufl.edu

Organizations & group practices 4

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": "1474416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492387200000",
    "number": "1376091165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4567 TEMPLE LAKES DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322577816",
            "telephone_number": "904-894-8469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2377 DUNN AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322186983",
            "telephone_number": "904-633-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "MICHELLE",
        "middle_name": "NICHOLE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-21",
        "last_updated": "2017-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9337907",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "ARNP9337907",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019282800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.