Individual provider Active NPI

Nicole Marie Walters, APRN

  • Family Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1386238012
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11009236 Issued in FL
Practice address
6879 Southpoint Dr N
Jacksonville, FL 32216-6179
Phone
(904) 296-2441
Fax
(888) 815-0833
NPI assigned
Feb 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11009236 FL
Family Nurse Practitioner 363LF0000X APRN11009236 FL Primary

Addresses

Primary practice location

6879 Southpoint Dr N
Jacksonville, FL 32216-6179

Mailing address

PO Box 748817
Atlanta, GA 30374-8817
Phone (813) 286-0033

Other practice location 1

1375 Nochaway Dr
Saint Augustine, FL 32092-1865
Phone (000) 000-0000

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
I20230727000864 FL Practitioner - Nurse Practitioner 9537520309 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Womens Care Florida LLCGroup PAC ID 9234031444, 324 clinicians

Practice addresses (Care Compare)

6879 Southpoint Dr N
Jacksonville, FL 32216-6179
Phone (904) 296-2441

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11009236FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Women'S Care Florida LLC Nurse Practitioner CurrentSince Mar 10, 2025 Accepting new patients
Womens' Health Hospitalists, LLC CurrentSince Mar 10, 2025 Accepting new patients

Locations

6879 Southpoint Dr N
Jacksonville, FL 32216
Phone (904) 296-2441

14540 Old St Augustine Rd
Ste 2499
Jacksonville, FL 32258
Phone (904) 296-2441

4030 W Boy Scout Blvd
Ste 800
Tampa, FL 33607
Phone (813) 286-0333

5002 W Lemon St
Tampa, FL 33609

2818 W Virginia Ave
Tampa, FL 33607
Phone (813) 872-8551

Organizations & group practices 2

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": "1614038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741564800000",
    "number": "1386238012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748817",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748817",
            "telephone_number": "813-286-0033",
            "fax_number": "813-282-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6879 SOUTHPOINT DR N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166179",
            "telephone_number": "904-296-2441",
            "fax_number": "888-815-0833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1375 Nochaway Dr",
            "address_purpose": "LOCATION",
            "city": "Saint Augustine",
            "state": "FL",
            "postal_code": "320921865",
            "country_code": "US",
            "telephone_number": "000-000-0000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-23",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11009236",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11009236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.