Individual provider Active NPI

Robert Bennett

  • Family Nurse Practitioner
  • Jensen Beach, FL
National Provider Identifier
1104333863
Registry record updated Jan 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9398782 Issued in FL
Practice address
407 NE Pecos Way
Jensen Beach, FL 34957-6692
Phone
(614) 314-9485
NPI assigned
Jan 3, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9398782 FL Primary

Addresses

Primary practice location

407 NE Pecos Way
Jensen Beach, FL 34957-6692

Mailing address

407 NE Pecos Way
Jensen Beach, FL 34957-6692
Phone (614) 314-9485

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20180307001099 FL Practitioner - Nurse Practitioner 2668733676 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP9398782FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Yampa Valley Medical Center CurrentSince May 8, 2023 Accepting new patients
Treasure Coast Medical Associates Current Accepting new patients
Michele F Libman MD PA CurrentSince Feb 17, 2019 Accepting new patients
Yampa Valley Medical Center CurrentSince May 8, 2023 Accepting new patients
Treasure Coast Medical Associates CurrentSince Jan 23, 2018 Accepting new patients
Yampa Valley Medical Center Past Accepting new patients

Locations

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

1024 Central Park Dr
Steamboat Springs, CO 80487
Phone (970) 824-1322

1600 Mid Valley Dr
Unit A
Steamboat Springs, CO 80487
Phone (970) 871-9770

3405 NW Federal Hwy
Jensen Beach, FL 34957
Phone (772) 692-8082

305 NE Park St
Okeechobee, FL 34972
Phone (772) 692-8082

1050 SE Monterey Rd
Ste 101
Stuart, FL 34994
Phone (772) 419-0560

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1514937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514937600000",
    "number": "1104333863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 NE PECOS WAY",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "349576692",
            "telephone_number": "614-314-9485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 NE PECOS WAY",
            "city": "JENSEN BEACH",
            "state": "FL",
            "postal_code": "349576692",
            "telephone_number": "614-314-9485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-03",
        "last_updated": "2018-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9398782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jensen Beach, FL

Sources for this page

Verify at the official NPI Registry.