Carol Jean Bennett, RD
Individual provider Active NPI Registered Dietitian · Colorado Springs, CO
NPI 1134460017 · NPPES record last updated Mar 2, 2013
Key facts
- NPI
- 1134460017
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 507482 (CO)
- Practice address
- 6475 Wall St
Suite 202
Colorado Springs, CO 80918-8337 - Phone
- (719) 265-6654
- Fax
- (719) 265-6650
- NPI assigned
- Mar 2, 2013
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 507482 | CO | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Dublin Dental Center | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 507482 | CO | Yes |
Addresses
Primary practice location
6475 Wall St
Suite 202
Colorado Springs, CO 80918-8337
Mailing address
6475 Wall St
Suite 202
Colorado Springs, CO 80918-8337
Phone (719) 265-6654
Other providers in Colorado Springs, CO
- Benjamin T Donn DDS PC
- Deirdre Anne Benjamin
- Nikki Benjamin
- Natalie Benko
- Bennett Medical Services
- Cedar Wray Bennett
- Cedrice Bennett
- Daniel Bennett
- Heidi Leea Bennett
- Mackenna Bennett
All providers in Colorado Springs, CO · Registered Dietitian in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.