Individual provider Active NPI

Victoria A Life

  • Pediatric Nurse Practitioner
  • Cedar Rapids, IA
National Provider Identifier
1679258230
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
146305 Issued in IA
Practice address
150 11TH Street NE
Cedar Rapids, IA 52402
Phone
(319) 369-7211
NPI assigned
Jun 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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 146305 IA Primary

Addresses

Primary practice location

150 11TH Street NE
Cedar Rapids, IA 52402

Mailing address

150 11TH Street NE
Cedar Rapids, IA 52402
Phone (319) 369-7211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20250605001958 IA Practitioner - Nurse Practitioner 4981113354 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
146305IAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Methodist Hospital CurrentSince Jun 30, 2025 Accepting new patients
St. Luke'S Methodist Hospital CurrentSince Jun 30, 2025 Accepting new patients
Trinity Regional Medical Center Past Accepting new patients

Locations

1026 A Ave NE
Cedar Rapids, IA 52402
Phone (319) 369-5970

Interoperability endpoints

  • Direct secure messaging: vlife428495@direct.unitypoint.org
  • Direct secure messaging: vlife656035@direct.ochin.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1679258230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 11TH STREET NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "52402",
            "telephone_number": "319-369-7211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 11TH STREET NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "52402",
            "telephone_number": "319-369-7211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIFE",
        "first_name": "VICTORIA",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-20",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IA",
            "license": "146305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.