Active NPI
Katie Rae Bennett, NP-C
- Family Nurse Practitioner
- Baltimore, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R158893
- Practice address
- 1000 E Eager St
Baltimore, MD 21202-5533 - Phone
- (410) 522-9800
- Fax
- (410) 522-5136
- NPI assigned
- Mar 1, 2009
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R158893 | MD | Primary |
Addresses
Primary practice location
1000 E Eager St
Baltimore, MD 21202-5533
Mailing address
3100 Wyman Park Dr
Baltimore, MD 21211-2803
Phone (410) 338-3500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
30 Northampton St
Boston, MA 02118-4098
Phone (617) 433-9601
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R158893 | MD | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boston'S Community Medical Group, Inc. | Current | Accepting new patients | |
| Matrix Medical Plus | Current | Accepting new patients | |
| Commonwealth Clinical Alliance, Inc | Current | Accepting new patients |
Locations
9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883
3 Allied Dr
Dedham, MA 02026
Phone (404) 587-0945
30 Northampton St
Roxbury, MA 02118
Phone (617) 433-9601
3550 Main St
Ste 101
Springfield, MA 01107
Phone (413) 739-0669
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.
-
- Primary Care Clinic/Center
- Boston, MA
- NPI 1235174418
-
- Case Manager/Care Coordinator
- Boston, MA
- NPI 1679605091
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352851200000",
"number": "1215177464",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 WYMAN PARK DR",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212112803",
"telephone_number": "410-338-3500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 E EAGER ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212025533",
"telephone_number": "410-522-9800",
"fax_number": "410-522-5136"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "KATIE",
"middle_name": "RAE",
"credential": "NP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-01",
"last_updated": "2012-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MD",
"license": "R158893",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2012; 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.