Individual provider Active NPI

Jennifer Concepcion, ARNP

  • Gerontology Nurse Practitioner
  • Cape Coral, FL
National Provider Identifier
1669276168
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
11038659 Issued in FL
Practice address
4419 Del Prado Blvd S Ste 4
Cape Coral, FL 33904-7460
Phone
(239) 541-8481
NPI assigned
Apr 3, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 11038659 FL Primary

Addresses

Primary practice location

4419 Del Prado Blvd S Ste 4
Cape Coral, FL 33904-7460

Mailing address

4419 Del Prado Blvd S Ste 4
Cape Coral, FL 33904-7460
Phone (239) 541-8481

Other names 1

  • Jennifer Rodriguez Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11038659FLMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jennifer Rodriguez Beauty Studio LLC CurrentSince Apr 6, 2025 Accepting new patients

Locations

4419 Del Prado Blvd S
Ste 4
Cape Coral, FL 33904
Phone (239) 541-1095

Organizations & group practices 1

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": "1743638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1669276168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4419 DEL PRADO BLVD S STE 4",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339047460",
            "telephone_number": "239-541-8481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4419 DEL PRADO BLVD S STE 4",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339047460",
            "telephone_number": "239-541-8481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONCEPCION",
        "first_name": "JENNIFER",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-03",
        "last_updated": "2025-04-03",
        "certification_date": "2025-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "11038659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "RODRIGUEZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.