Laurren Ashley Bennett, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-2020 Issued in ID

Practice address

740 S Woodruff Ave
Idaho Falls, ID 83401-5285

Phone

(209) 542-9111

NPI assigned

Feb 17, 2021

Last updated

Feb 17, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tony C Roisum MD PAGroup PAC ID 5991094864, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Brio Idaho Healthcare Home health agency, Idaho Falls, ID, CCN 137128
• Aspen Home Health Services Home health agency, Idaho Falls, ID, CCN 137081
• Mountain View Hospital Hospital, Idaho Falls, ID, CCN 130065

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FEHIBD/Endpoint/FEHIBD

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.

• Tony C Roisum MD PA

  dba Idaho Falls Family & Sports Medicine

  • Family Medicine Physician
  • Idaho Falls, ID
  • NPI 1124115944
  Medicare reassignment Care Compare group
• Sterling Provider Group

  • Urgent Care Clinic/Center
  • Idaho Falls, ID
  • NPI 1205300407
  Medicare reassignment
• Urgent Care Associates PLLC

  • Preferred Provider Organization
  • Idaho Falls, ID
  • NPI 1609046408
  NPD
• Sterling Provider Group

  • Urgent Care Clinic/Center
  • Butte, MT
  • NPI 1871220038
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Brio Idaho Home Health LLC

  • Home Health Agency
  • Idaho Falls, ID
  • NPI 1285189548
  Care Compare affiliation
• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Care Compare affiliation
• The Aspen Group, Inc.

  dba Aspen Home Health

  • Home Health Agency
  • Idaho Falls, ID
  • NPI 1083760185
  Care Compare affiliation

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

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1104419431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 KIMBERLY DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834013838",
            "telephone_number": "208-520-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 S WOODRUFF AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834015285",
            "telephone_number": "209-542-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "LAURREN",
        "middle_name": "ASHLEY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-17",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-2020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas R. Bench, D.C.
• Benchmark Home Health
• Barry Bennett, MD
• Braden Bennett, PT, DPT
• Eric Bennett, M.D.
• Maialisa Bennett
• Mark Barry Bennett, LMSW
• Ashley Benson, LCSW
• Elsa Marie Benson, LMSW
• Richard Whiting Bentley, M.D.

• Physician Assistant in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.