Individual provider Active NPI

Victoria Waltrip, APRN

  • Nurse Practitioner
  • Orange Park, FL
National Provider Identifier
1689356412
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11027298 Issued in FL
Practice address
2966 Lakeside Villa Dr
Orange Park, FL 32073-6420
Phone
(904) 334-6887
NPI assigned
Aug 2, 2023
Last updated
Aug 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11027298 FL Primary

Addresses

Primary practice location

2966 Lakeside Villa Dr
Orange Park, FL 32073-6420

Mailing address

2966 Lakeside Villa Dr
Orange Park, FL 32073-6420
Phone (904) 334-6887

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
I20251008000164 FL Practitioner - Nurse Practitioner 8224535141 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Balanced Wellbeing LLCGroup PAC ID 5193021848, 228 clinicians

Practice addresses (Care Compare)

22385 Flora Parke Xing
Fernandina Beach, FL 32034-8000
Phone (904) 404-8641

3200 SW 34TH Ave
Suite 701
Ocala, FL 34474-8443
Phone (877) 779-2429

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11027298FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Community Health Services, Inc. CurrentSince Sep 22, 2025 Accepting new patients
Balanced Wellbeing LLC CurrentSince Sep 22, 2025 Accepting new patients
Coastal Community Health Services, Inc. CurrentSince Sep 22, 2025 Accepting new patients

Locations

22385 Flora Parke Xing
Fernandina Beach, FL 32034
Phone (904) 404-8641

3200 SW 34th Ave
Ste 701
Ocala, FL 34474
Phone (354) 445-1200

106 Shoppers Way
Ste 101
Brunswick, GA 31525
Phone (912) 275-8208

1022 Miller Ln SW
Darien, GA 31305
Phone (912) 257-8028

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": "1690934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1689356412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2966 LAKESIDE VILLA DR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320736420",
            "telephone_number": "904-334-6887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2966 LAKESIDE VILLA DR",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320736420",
            "telephone_number": "904-334-6887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTRIP",
        "first_name": "VICTORIA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-02",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11027298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.