Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Derric James Vigeant

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1902546203

Derric James Vigeant is a Physician Assistant in Providence, Rhode Island. Qualified in 2022, 4 years ago. Practices with Supportive Care I of Rhode Island PC, a 54-clinician group and accepts Medicare assignment. Licensed in Rhode Island.

Years since qualifying
4
Licensed in
RI
In the registry since
2022
Specialties on file
3
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Practice location Address checks out

825 Chalkstone Ave
Providence, RI 02908-4728
Phone: (401) 456-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence PA1450 (RI)
Child & Family Psychiatric/Mental Health Clinical Nurse Specialist Taxonomy 364SP0810X · Licence PA01450 (RI)

Record details

NPI number1902546203
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 1, 2022
Last updated in NPPESMay 9, 2022
Certification dateMay 9, 2022
Mailing address646 Greenville Ave, Johnston, RI 02919-1331

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Supportive Care I Of Rhode Island Pc — 54 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Providence