Individual provider Active NPI

Laura Viksnins, CPNP-PC

  • Pediatric Nurse Practitioner
  • Lake City, FL
National Provider Identifier
1487396966
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
11018989 Issued in FL
Practice address
1859 SW Newland Way
Lake City, FL 32025-6966
Phone
(386) 758-0003
NPI assigned
Apr 13, 2022
Last updated
Apr 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 11018989 FL Primary

Addresses

Primary practice location

1859 SW Newland Way
Lake City, FL 32025-6966

Mailing address

3 Woodcock Rd Unit 5114
Savannah, GA 31404-1097
Phone (651) 238-1424

Other practice location 1

417 E Call St
Starke, FL 32091-3401
Phone (904) 368-0368

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20250520004558 DC Practitioner - Nurse Practitioner 0840718086 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11018989FLMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital CurrentSince May 2, 2025 Accepting new patients
Children's Hospital CurrentSince May 2, 2025 Accepting new patients
Children's Hospital Current Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

7125 13th Pl NW
Washington, DC 20012
Phone (202) 545-2500

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1649808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1487396966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 WOODCOCK RD UNIT 5114",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314041097",
            "telephone_number": "651-238-1424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1859 SW NEWLAND WAY",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320256966",
            "telephone_number": "386-758-0003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "417 E Call St",
            "address_purpose": "LOCATION",
            "city": "Starke",
            "state": "FL",
            "postal_code": "320913401",
            "country_code": "US",
            "telephone_number": "904-368-0368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VIKSNINS",
        "first_name": "LAURA",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-13",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "11018989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

Verify at the official NPI Registry.