Individual provider Active NPI

Kristin L Soccio, NP

  • Pediatric Nurse Practitioner
  • Providence, RI
National Provider Identifier
1578619532
Registry record updated Jan 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
NP36940 Issued in RI
Practice address
593 Eddy St
Providence, RI 02903-4923
Phone
(401) 444-4201
Fax
(401) 444-5527
NPI assigned
Jan 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2014

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 NP36940 RI Primary

Addresses

Primary practice location

593 Eddy St
Providence, RI 02903-4923

Mailing address

593 Eddy St
Hasbro 122
Providence, RI 02903-4923
Phone (401) 444-4201

Other names 1

  • Kristin L Warren Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20070427000568 RI Practitioner - Nurse Practitioner 5193821734 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rhode Island HospitalGroup PAC ID 8921900044, 430 clinicians

Practice addresses (Care Compare)

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-5241

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP36940RIMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital CurrentSince Apr 10, 2018 Accepting new patients
Rhode Island Hospital CurrentSince Apr 10, 2018 Accepting new patients
Rhode Island Hospital Past Accepting new patients
Rhode Island Hospital Past Accepting new patients

Locations

593 Eddy St
Ste 105
Providence, RI 02903
Phone (401) 444-5241

593 Eddy St
Ste 5
Providence, RI 02903
Phone (401) 444-3996

593 Eddy St
#122
Providence, RI 02903
Phone (401) 444-6195

593 Eddy St
Providence, RI 02903

593 Eddy St
#921
Providence, RI 02903
Phone (401) 444-3250

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.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390176000000",
    "number": "1578619532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "address_2": "HASBRO 122",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-4201",
            "fax_number": "401-444-5527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-4201",
            "fax_number": "401-444-5527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOCCIO",
        "first_name": "KRISTIN",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2014-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "RI",
            "license": "NP36940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "WARREN",
            "middle_name": "L",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.