Active NPI
Richard Joseph Bennett, CATC II
- Rehabilitation Practitioner
- Azusa, CA
National Provider Identifier
1174893853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 23701 E East Fork Rd
Azusa, CA 91702-1477 - Phone
- (626) 250-3290
- NPI assigned
- Jan 11, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | Primary |
Addresses
Primary practice location
23701 E East Fork Rd
Azusa, CA 91702-1477
Mailing address
23701 E East Fork Rd
Azusa, CA 91702-1477
Phone (626) 250-3290
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326240000000",
"number": "1174893853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23701 E EAST FORK RD",
"city": "AZUSA",
"state": "CA",
"postal_code": "917021477",
"telephone_number": "626-250-3290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23701 E EAST FORK RD",
"city": "AZUSA",
"state": "CA",
"postal_code": "917021477",
"telephone_number": "626-250-3290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "RICHARD",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "CATC II",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-01-11",
"last_updated": "2012-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Azusa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.