Active NPI
Bennett Clinic LLC
Doing business as Bennett Clinic
- Physical Therapy Clinic/Center
- Prescott Valley, AZ
National Provider Identifier
1104167444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Clinic/Center
- License
- PT 6078
- Legal business name
- BENNETT CLINIC LLC
- Doing business as
- Bennett Clinic
- Practice address
- 7876 E Florentine Rd
Prescott Valley, AZ 86314-2216 - Phone
- (928) 772-7200
- Fax
- (928) 772-7779
- NPI assigned
- Mar 12, 2013
- Last updated
- Mar 12, 2013
- 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
- Mrs. Mary Evelyn Bennett, R.N.
- Title
- Partner
- Phone
- (928) 772-7200
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | PT 6078 | AZ | Primary |
Addresses
Primary practice location
7876 E Florentine Rd
Prescott Valley, AZ 86314-2216
Mailing address
7876 E Florentine Rd
Prescott Valley, AZ 86314-2216
Phone (928) 772-7200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Z90034 | Other | AZ | MEDICARE PTAN |
Other names 1
- Bennett Clinic
National Provider Directory
National Provider Directory- Tax ID family
- Bennett Clinic
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
Locations
7876 E Florentine Rd
Prescott Vly, AZ 86314
Phone (928) 772-7200
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363046400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1363046400000",
"number": "1104167444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7876 E FLORENTINE RD",
"city": "PRESCOTT VALLEY",
"state": "AZ",
"postal_code": "863142216",
"telephone_number": "928-772-7200",
"fax_number": "928-772-7779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7876 E FLORENTINE RD",
"city": "PRESCOTT VALLEY",
"state": "AZ",
"postal_code": "863142216",
"telephone_number": "928-772-7200",
"fax_number": "928-772-7779"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BENNETT CLINIC LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-03-12",
"last_updated": "2013-03-12",
"status": "A",
"authorized_official_last_name": "BENNETT",
"authorized_official_first_name": "MARY",
"authorized_official_middle_name": "EVELYN",
"authorized_official_title_or_position": "PARTNER",
"authorized_official_telephone_number": "928-772-7200",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "R.N."
},
"taxonomies": [
{
"code": "261QP2000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Physical Therapy",
"state": "AZ",
"license": "PT 6078",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "Z90034",
"state": "AZ"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Bennett Clinic",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Prescott Valley, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.