Phillip Charles Bennett, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PS008447L Issued in PA

Practice address

2401 Pennsylvania Ave
Suite 1C-51
Philadelphia, PA 19130-3010

Phone

(215) 496-9091

Fax

(215) 951-6273

NPI assigned

Apr 12, 2007

Last updated

Jun 19, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434672000000",
    "number": "1205050978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 PENNSYLVANIA AVE",
            "address_2": "SUITE 1C-51",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191303010",
            "telephone_number": "215-496-9091",
            "fax_number": "215-951-6273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 PENNSYLVANIA AVE",
            "address_2": "SUITE 1C-51",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191303010",
            "telephone_number": "215-496-9091",
            "fax_number": "215-951-6273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "PHILLIP",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2015-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS008447L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariko Bennett, MD, PHD
• Michael J Bennett, PH.D.
• Nadia L Bennett, MD
• Nia Bennett, LPN
• Nicholas Nathaniel Bennett
• Rachel Mackenzie Bennett, MD
• Ralph Bennett, CRNA
• Richard H Bennett, MD
• Rosangela Oliveira Bennett
• Shameka Bennett

• Psychologist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2015; 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.