Active NPI
Michelle Nichole Waters, ARNP
- Family Nurse Practitioner
- Jacksonville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- ARNP9337907
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 019282800 | Medicaid | FL |
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
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 59.59 of 100
- Quality
- 59.93
- Promoting interoperability
- 0
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP9337907 | FL | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Florida Jacksonville 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 | |
| Virta Medical P.C. | Current | 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
- 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.
-
- Diagnostic Radiology Physician
- Jacksonville, FL
- NPI 1326208695
-
- Family Medicine Physician
- Jacksonville, FL
- NPI 1487814752
-
- Physiological Laboratory
- Jacksonville, FL
- NPI 1831800952
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2017; 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.