Justin Baines Bennett

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

110892 Issued in WV

Practice address

4314 Williamstown Pike
Williamstown, WV 26187-8083

Phone

(304) 482-6029

NPI assigned

Sep 20, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

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

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. Joseph Recovery Center, LLCGroup PAC ID 0042548000, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• St. Joseph Recovery Center, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Parkersburg, WV
  • NPI 1174021406
  Medicare reassignment Care Compare group
• Matrix Medical Network of West

  • Nurse Practitioner
  • Scottsdale, AZ
  • NPI 1942569033

  WV

  Medicare reassignment NPD
• Matrix Medical Plus

  • Nurse Practitioner
  • Nashville, TN
  • NPI 1376973461

  WV

  Medicare reassignment NPD
• Grace Medical Group, LLC

  • Family Nurse Practitioner
  • Parkersburg, WV
  • NPI 1376172494
  Medicare reassignment

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

{
    "created_epoch": "1632096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1174293138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4314 WILLIAMSTOWN PIKE",
            "city": "WILLIAMSTOWN",
            "state": "WV",
            "postal_code": "261878083",
            "telephone_number": "304-482-6029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4314 WILLIAMSTOWN PIKE",
            "city": "WILLIAMSTOWN",
            "state": "WV",
            "postal_code": "261878083",
            "telephone_number": "304-482-6029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "JUSTIN",
        "middle_name": "BAINES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-20",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "OH",
            "license": "RN.385551",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "LE-00038485",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "110892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debbie Barnhart
• Pamela Kim Barnhart
• Amanda Bartlett, SERVICE COORDINATOR
• Regina Danielle Bartley
• Alice O Bauerbach
• Tammy Rose Billiter
• Caleb Bland
• Lyndsay Boley
• Aimee M Bowman
• Derrick Lee Briggs

• Family Nurse Practitioner in Williamstown, WV
• Providers in Williamstown, WV by specialty
• Family Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; 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.