Nelson Charles Bennett, M.D.
Individual provider Active NPI Psychiatry Physician · Atlanta, GA
NPI 1104150499 · NPPES record last updated Sep 21, 2009
Key facts
- NPI
- 1104150499
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 032873 (GA)
- Practice address
- 34 Peachtree St
Suite 770
Atlanta, GA 30303-2316 - Phone
- (404) 507-7100
- NPI assigned
- Sep 21, 2009
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2016 through Jan 1, 2028
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 032873 | GA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pathways Center for Behavioral and Developmental Growth | Past | Accepting new patients | |
| MHM Services, Inc. | Past | Accepting new patients | |
| Pathways Center for Behavioral & Developmental Growth | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 032873 | GA | Yes |
Addresses
Primary practice location
34 Peachtree St
Suite 770
Atlanta, GA 30303-2316
Mailing address
703 Alderly LN
Peachtree City, GA 30269-1154
Phone (770) 631-1322
Other providers in Atlanta, GA
- Mackenzie Price Bennett
- Mark Sean Bennett
- Matthew Ryan Bennett
- Nancy Della Bennett
- Natasha Bennett
- Raven Bennett
- Samuel Bennett
- Sara Ruth Bennett
- Sarah Denise Bennett
- Sindi S Bennett
All providers in Atlanta, GA · Psychiatry Physician in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 21, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.