Everett G. Bennett III, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

53-77127-041 Issued in KS

Practice address

11001 Hauser St
Lenexa, KS 66210-3708

Phone

(913) 353-4703

Fax

(913) 353-4031

NPI assigned

Feb 23, 2016

Last updated

Aug 8, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Trey Bennett Other name

Medicare fee-for-service enrollment

Enrolled in KS

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Integrative Health Providers LLC

  dba Vitality Lifestyle Medicine

  • Adult Health Nurse Practitioner
  • Lenexa, KS
  • NPI 1801325659
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1456185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1033578752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 HAUSER ST.",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "66210",
            "telephone_number": "913-353-4703",
            "fax_number": "949-543-2954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11001 HAUSER ST",
            "city": "LENEXA",
            "state": "KS",
            "postal_code": "662103708",
            "telephone_number": "913-353-4703",
            "fax_number": "913-353-4031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "EVERETT",
        "middle_name": "G.",
        "name_suffix": "III",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-23",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "53-77127-041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TREY",
            "last_name": "BENNETT",
            "credential": "NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Aaron Matthew Bellelo
• Kelsey Bellew
• Ted Duane Bender, D.C.
• Bilhah Nanjala Wafula Bengi
• Angela Bennett, PTA
• Jandra Bennett
• Sierra Bennett
• Rhonda G Berg
• Ashton Makaila Bergh, FNP - BC, C
• Nora Katherine Berkbigler

• Nurse Practitioner in Lenexa, KS
• Providers in Lenexa, KS by specialty
• Nurse Practitioner in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.