NPIMap

Individual provider Active NPI

Garrison S. Bennett, MD

  • Family Medicine Physician
  • Midlothian, VA
National Provider Identifier
1114990009
Registry record updated Jul 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101-102655 Issued in VA
Practice address
15769 WC Main St
Midlothian, VA 23113-7327
Phone
(804) 419-9760
Fax
(804) 378-9140
NPI assigned
Feb 10, 2006
Last updated
Jul 25, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0101102655 VA
Family Medicine Physician 207Q00000X 0101-102655 VA Primary

Addresses

Primary practice location

15769 WC Main St
Midlothian, VA 23113-7327

Mailing address

3000 Watercove Rd
Midlothian, VA 23112
Phone (804) 744-8140

Other identifiers 12

IdentifierTypeStateIssuer
540883363OtherVAPHCS
540883363OtherVAVIRGINIA HEALTH NETWORK
1114990009MedicaidVA
540883363OtherVAGREAT WEST
726824OtherVASOUTHERN HEALTH
10002698OtherVAOPTIMA
5163353OtherVAMAMSI
308372OtherVAANTHEM
540883363OtherVAPREFERRED CARE
7076211OtherVAAETNA
5163353OtherVAUNITED HEALTHCARE
3071733OtherVACIGNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031210001157 VA Practitioner - Family Practice 3173429065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Eastern Virginia Medical School, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virginia Physicians IncGroup PAC ID 5597650804, 93 clinicians

Practice addresses (Care Compare)

15769 WC Main St
Midlothian, VA 23113-7327
Phone (804) 419-9760

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101102655VAMDSpecialist
0101-102655VAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Physicians Inc Specialist Current Accepting new patients
NPI 1477614964 CurrentSince Jan 28, 2008 Accepting new patients
Virginia Physicians Inc Specialist Current Accepting new patients
Virginia Physicians Inc Specialist CurrentSince Jan 28, 2008 Accepting new patients
Virginia Physicians Inc Specialist Past Accepting new patients
Carilion Healthcare Corporation Past Accepting new patients
Carilion Healthcare Corporation Past Accepting new patients

Locations

13332 Midlothian Tpke
Midlothian, VA 23113
Phone (804) 794-5598

15769 Wc Main St
Midlothian, VA 23113
Phone (804) 419-9760

3000 Watercove Rd
Midlothian, VA 23112
Phone (804) 744-0200

2891 Anderson Hwy
Powhatan, VA 23139
Phone (804) 267-6920

3510 Anderson Hwy
Ste A
Powhatan, VA 23139
Phone (804) 598-3100

Interoperability endpoints

  • Direct secure messaging: garrison.bennett@vpi.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374710400000",
    "number": "1114990009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 WATERCOVE RD",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "23112",
            "telephone_number": "804-744-8140",
            "fax_number": "804-744-7390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15769 WC MAIN ST",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231137327",
            "telephone_number": "804-419-9760",
            "fax_number": "804-378-9140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "GARRISON",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2013-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101102655",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101-102655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "540883363",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA HEALTH NETWORK",
            "identifier": "540883363",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114990009",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT WEST",
            "identifier": "540883363",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH",
            "identifier": "726824",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA",
            "identifier": "10002698",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "5163353",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "308372",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE",
            "identifier": "540883363",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7076211",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "5163353",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3071733",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

Verify at the official NPI Registry.