Individual provider Active NPI

Jennifer Soto, AGPCNP - APRN

  • Gerontology Nurse Practitioner
  • East Greenwich, RI
National Provider Identifier
1760115620
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN05278 Issued in RI
Practice address
1405 S County TRL Ste 1a
East Greenwich, RI 02818-5081
Phone
(401) 921-7290
Fax
(401) 921-6194
NPI assigned
Jul 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN05278 RI
Gerontology Nurse Practitioner 363LG0600X APRN05278 RI Primary

Addresses

Primary practice location

1405 S County TRL Ste 1a
East Greenwich, RI 02818-5081

Mailing address

455 Toll Gate Rd
PRC and Credentialing
Warwick, RI 02886
Phone (401) 273-0641

Other practice location 1

215 Toll Gate Rd Ste 104
Warwick, RI 02886-4463
Phone (401) 736-4576

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
I20240618002998 FL Practitioner - Nurse Practitioner 2062955024 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AG10230075FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cardiac Vision LLC CurrentSince May 9, 2025 Accepting new patients
Premier Community Healthcare Group, Inc. CurrentSince Apr 13, 2024 Accepting new patients
Premier Community Healthcare Group Inc CurrentSince Apr 13, 2024 Accepting new patients

Locations

14027 5th St
Dade City, FL 33525
Phone (813) 782-6064

6817 Southpoint Pkwy
Ste 203
Jacksonville, FL 32216
Phone (904) 256-9202

7807 Baymeadows Rd E
Ste 209
Jacksonville, FL 32256
Phone (904) 231-1204

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": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1760115620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 TOLL GATE RD",
            "address_2": "PRC AND CREDENTIALING",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "02886",
            "telephone_number": "401-273-0641",
            "fax_number": "401-273-2919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 S COUNTY TRL STE 1A",
            "city": "EAST GREENWICH",
            "state": "RI",
            "postal_code": "028185081",
            "telephone_number": "401-921-7290",
            "fax_number": "401-921-6194"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 Toll Gate Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028864463",
            "country_code": "US",
            "telephone_number": "401-736-4576",
            "fax_number": "401-921-9882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOTO",
        "first_name": "JENNIFER",
        "name_prefix": "Mrs.",
        "credential": "AGPCNP - APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-07",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "RI",
            "license": "APRN05278",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "RI",
            "license": "APRN05278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Greenwich, RI

Sources for this page

Verify at the official NPI Registry.