Jacob Alan Bennett

Primary specialty

Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X

License

28580 Issued in SC

Practice address

25 Courtenay Dr Ste 4200
Charleston, SC 29425-4001

Phone

(843) 876-5744

NPI assigned

Aug 28, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Medical Associates of the Medical University of South CarolGroup PAC ID 6305758574, 1,634 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Musc Medical Center Hospital, Charleston, SC, CCN 420004

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• University Medical Associates of the Medical University of South Carol

  • Multi-Specialty Clinic/Center
  • Charleston, SC
  • NPI 1043241110
  Medicare reassignment Care Compare group NPD
• University Medical Associates of the Medical University of South Carol

  • Family Medicine Physician
  • Charleston, SC
  • NPI 1982678496
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Medical University Hospital Authority

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1073605879
  Care Compare affiliation
• Medical University Hospital Authority

  • Rehabilitation Hospital
  • Orangeburg, SC
  • NPI 1154020147
  Care Compare affiliation
• Medical University Hospital Authority

  • General Acute Care Hospital
  • Charleston, SC
  • NPI 1659435840
  Care Compare affiliation
• Medical University Hospital Authority

  • Psychiatric Hospital
  • Orangeburg, SC
  • NPI 1669171740
  Care Compare affiliation
• Medical University Hospital Authority

  • General Acute Care Hospital
  • Orangeburg, SC
  • NPI 1710683354
  Care Compare affiliation
• Medical University Hospital Authority

  • General Acute Care Hospital
  • Orangeburg, SC
  • NPI 1770280299
  Care Compare affiliation

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

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1083499297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751461",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751461",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 COURTENAY DR STE 4200",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294254001",
            "telephone_number": "843-876-5744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "JACOB",
        "middle_name": "ALAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-28",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "SC",
            "license": "28580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Evan Benjamin, M.D.
• Merve Benli
• Carolyn Annette Bennett, REGISTERED NURSE
• Cierra Christine Bennett, CRNA
• Heidi L Bennett, R.N.
• Jeffery Rusten Bennett, MD
• Jennifer Bennett, MA, MA, LPCI
• Katherine Bennett, DPT
• Lori W Bennett, PHARMD, BCPS
• Nicole Bennett, PHARMACIST

• Critical Care Medicine Nurse Practitioner in Charleston, SC
• Providers in Charleston, SC by specialty
• Critical Care Medicine Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 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.