Active NPI
Bennett W McAllister MD PA
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Port Charlotte, FL
National Provider Identifier
1104154053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Legal business name
- BENNETT W MCALLISTER MD PA
- Practice address
- 4161 Tamiami TRL Ste 304D
Port Charlotte, FL 33952-9254 - Phone
- (941) 625-5895
- Fax
- (941) 625-1047
- NPI assigned
- Dec 3, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Bennett William McAllister, MD
- Title
- Owner
- Phone
- (941) 625-5895
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | ME104685 | FL | |
| Psychiatry Physician | 2084P0800X | |||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Primary | ||
| Adult Mental Health Clinic/Center | 261QM0850X |
Addresses
Primary practice location
4161 Tamiami TRL Ste 304D
Port Charlotte, FL 33952-9254
Mailing address
PO Box 512139
Punta Gorda, FL 33951-2139
Phone (941) 625-5895
Other practice location 1
900 SW Pine Island Rd Ste 207
Cape Coral, FL 33991-1982
Phone (941) 625-5895
Other practice location 2
7317 Merchant Ct Ste A
Lakewood Ranch, FL 34240-8464
Phone (941) 625-5895
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001284200 | Medicaid | FL | |
| 114514100 | Medicaid | FL |
Other names 1
- Lighthouse Psychiatry
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100218000400 | FL | Part B Supplier - Clinic/Group Practice | 3678617347 |
Receives reassigned benefits from 9 practitioners Practice locations: Port Charlotte, FL; Lakewood Ranch, FL |
National Provider Directory
National Provider DirectoryLocations
7317 Merchant Ct
Ste A
Lakewood Ranch, FL 34240
Phone (941) 625-5895
2525 Harbor Blvd
Ste 312
Pt Charlotte, FL 33952
Phone (941) 228-3562
4161 Tamiami Trl
Ste 304D
Pt Charlotte, FL 33952
Phone (941) 625-5895
Practitioners & affiliated clinicians
Practitioners 9
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatry Physician
- Port Charlotte, FL
- NPI 1275704157
FL, Psychiatry
-
- Psychiatric/Mental Health Nurse Practitioner
- Punta Gorda, FL
- NPI 1336603588
FL, Single Specialty
-
- Psychiatric/Mental Health Nurse Practitioner
- Lakewood Ranch, FL
- NPI 1396327086
FL
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1259798400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788998400000",
"number": "1104154053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 512139",
"city": "PUNTA GORDA",
"state": "FL",
"postal_code": "339512139",
"telephone_number": "941-625-5895",
"fax_number": "941-625-1047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4161 TAMIAMI TRL STE 304D",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "339529254",
"telephone_number": "941-625-5895",
"fax_number": "941-625-1047"
}
],
"practiceLocations": [
{
"address_1": "900 SW Pine Island Rd Ste 207",
"address_purpose": "LOCATION",
"city": "Cape Coral",
"state": "FL",
"postal_code": "339911982",
"country_code": "US",
"telephone_number": "941-625-5895",
"fax_number": "941-625-1047",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "7317 Merchant Ct Ste A",
"address_purpose": "LOCATION",
"city": "Lakewood Ranch",
"state": "FL",
"postal_code": "342408464",
"country_code": "US",
"telephone_number": "941-625-5895",
"fax_number": "941-625-1047",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "BENNETT W MCALLISTER MD PA",
"organizational_subpart": "NO",
"enumeration_date": "2009-12-03",
"last_updated": "2026-09-10",
"certification_date": "2026-09-10",
"status": "A",
"authorized_official_last_name": "MCALLISTER",
"authorized_official_first_name": "BENNETT",
"authorized_official_middle_name": "WILLIAM",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "941-625-5895",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "FL",
"license": "ME104685",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QM0850X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Mental Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001284200",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "114514100",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Lighthouse Psychiatry",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Port Charlotte, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.