Individual provider Active NPI

Kaitlyn A Bennett, NP

  • Family Nurse Practitioner
  • Scottsboro, AL
National Provider Identifier
1154910123
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-168707 Issued in AL
Practice address
508 Harley St Ste D
Scottsboro, AL 35768-4263
Phone
(256) 259-6054
NPI assigned
Jan 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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 1-168707 AL Primary

Addresses

Primary practice location

508 Harley St Ste D
Scottsboro, AL 35768-4263

Mailing address

508 Harley St Ste D
Scottsboro, AL 35768-4263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20210302002365 AL Practitioner - Nurse Practitioner 6305252107 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthpointe 9 clinicians

Practice addresses (Care Compare)

24020 John T Reid Pkwy
Scottsboro, AL 35768-2855
Phone (256) 594-8181

Hospital & facility affiliations

  • Highlands Medical Center Hospital, Scottsboro, AL, CCN 010061

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-168707ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Scottsboro ENT, PC CurrentSince Jun 11, 2023 Accepting new patients
Dekalb Specialty Care CurrentSince Feb 17, 2025 Accepting new patients
Healthpointe CurrentSince Sep 30, 2024 Accepting new patients

Locations

423 Medical Center Dr SW
Fort Payne, AL 35968
Phone (256) 844-8144

406 Taylor St
Ste B
Scottsboro, AL 35768
Phone (256) 574-6100

24020 John T Reid Pkwy
Scottsboro, AL 35768
Phone (256) 574-3491

Interoperability endpoints

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

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1610582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1154910123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 HARLEY ST STE D",
            "city": "SCOTTSBORO",
            "state": "AL",
            "postal_code": "357684263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 HARLEY ST STE D",
            "city": "SCOTTSBORO",
            "state": "AL",
            "postal_code": "357684263",
            "telephone_number": "256-259-6054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "KAITLYN",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-14",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-168707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsboro, AL

Sources for this page

Verify at the official NPI Registry.