Active NPI
Cynthia Elaine Bennett, M.D.
- Rehabilitation Practitioner
- Colorado SPGS, CO
National Provider Identifier
1063491199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- License
- 41710
- Practice address
- 2222 N Nevada Ave
Ste 5020
Colorado SPGS, CO 80907-6868 - Phone
- (719) 776-5960
- Fax
- (719) 776-5045
- NPI assigned
- Jan 17, 2006
- Last updated
- Nov 24, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neuromusculoskeletal Medicine & OMM Physician | 204D00000X | MD00048553 | WA | |
| Rehabilitation Practitioner | 225400000X | 41710 | CO | Primary |
Addresses
Primary practice location
2222 N Nevada Ave
Ste 5020
Colorado SPGS, CO 80907-6868
Mailing address
2222 N Nevada Ave
Ste 5020
Colorado SPGS, CO 80907-6868
Phone (719) 776-5960
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 80031064 | Medicaid | CO | |
| 5160BE | Other | WA | BLUE SHIELD VM |
| 8493199 | Medicaid | WA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41710 | CO | MD | Rehabilitation Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227484800000",
"number": "1063491199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2222 N NEVADA AVE",
"address_2": "STE 5020",
"city": "COLORADO SPGS",
"state": "CO",
"postal_code": "809076868",
"telephone_number": "719-776-5960",
"fax_number": "719-776-5045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2222 N NEVADA AVE",
"address_2": "STE 5020",
"city": "COLORADO SPGS",
"state": "CO",
"postal_code": "809076868",
"telephone_number": "719-776-5960",
"fax_number": "719-776-5045"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "CYNTHIA",
"middle_name": "ELAINE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-17",
"last_updated": "2008-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "204D00000X",
"taxonomy_group": "",
"desc": "Neuromusculoskeletal Medicine & OMM",
"state": "WA",
"license": "MD00048553",
"primary": false
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "CO",
"license": "41710",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "80031064",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD VM",
"identifier": "5160BE",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8493199",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Colorado SPGS, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.