Active NPI
Cristie Bennett, P.T.
- Physical Medicine & Rehabilitation Physician
- Novato, CA
National Provider Identifier
1104153360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 36186
- Practice address
- 165 Rowland Way
Ste. 101
Novato, CA 94945-5038 - Phone
- (415) 898-1311
- NPI assigned
- Nov 9, 2009
- Last updated
- Jan 27, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 36186 | CA | Primary |
Addresses
Primary practice location
165 Rowland Way
Ste. 101
Novato, CA 94945-5038
Mailing address
11 Walker Rd
Mill Valley, CA 94941-1682
Phone (530) 400-8532
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36186 | CA | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Novato Back Care and Sports Physical Therapy | Past | Accepting new patients | |
| Sport & Spine Therapy of Marin Inc | Past | Accepting new patients | |
| Sport & Spine Therapy of Marin Inc | Past | Accepting new patients |
Organizations & group practices 3
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264550400000",
"number": "1104153360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11 WALKER RD",
"city": "MILL VALLEY",
"state": "CA",
"postal_code": "949411682",
"telephone_number": "530-400-8532"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "165 ROWLAND WAY",
"address_2": "STE. 101",
"city": "NOVATO",
"state": "CA",
"postal_code": "949455038",
"telephone_number": "415-898-1311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "CRISTIE",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-09",
"last_updated": "2010-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "CA",
"license": "36186",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Novato, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.