Individual provider Active NPI

Jennifer Henson Soriano, PT

  • Physical Therapist
  • Lakeland, FL
National Provider Identifier
1831555127
Registry record updated Apr 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16870 Issued in FL
Practice address
2225 E Edgewood Dr
Suite 5
Lakeland, FL 33803-3634
Phone
(863) 513-9054
Fax
(863) 583-0390
NPI assigned
Jan 3, 2016
Last updated
Apr 4, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 16870 FL Primary

Addresses

Primary practice location

2225 E Edgewood Dr
Suite 5
Lakeland, FL 33803-3634

Mailing address

2225 E Edgewood Dr
Suite 5
Lakeland, FL 33803-3634
Phone (863) 513-9054

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160719000620 FL Practitioner - Physical Therapist in Private Practice 0042517088 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ally Rehab, LLC Physical Therapist CurrentSince Jan 3, 2026 Accepting new patients

Organizations & group practices 2

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": "1451779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459728000000",
    "number": "1831555127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 E EDGEWOOD DR",
            "address_2": "SUITE 5",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338033634",
            "telephone_number": "863-513-9054",
            "fax_number": "863-583-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 E EDGEWOOD DR",
            "address_2": "SUITE 5",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338033634",
            "telephone_number": "863-513-9054",
            "fax_number": "863-583-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORIANO",
        "first_name": "JENNIFER",
        "middle_name": "HENSON",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-03",
        "last_updated": "2016-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "16870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.