Dessirae Marie Bennett, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

321110 Issued in NC

Practice address

3333 Wrightsville Ave Ste M
Wilmington, NC 28403-4115

Phone

(910) 399-3519

Fax

(910) 769-1739

NPI assigned

Aug 2, 2022

Last updated

Aug 2, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Perihan S. Warren, FNP-C , LLC.

  dba Azalea Coast Behavioral Health

  • Family Nurse Practitioner
  • Wilmington, NC
  • NPI 1386100360

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1659398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1225765118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 WRIGHTSVILLE AVE STE M",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034115",
            "telephone_number": "910-399-3519",
            "fax_number": "910-769-1739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 WRIGHTSVILLE AVE STE M",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034115",
            "telephone_number": "910-399-3519",
            "fax_number": "910-769-1739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "DESSIRAE",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-02",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "321110",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "321110",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NC",
            "license": "321110",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NC",
            "license": "321110",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Paul Benjamin, M.D.
• Alannah Bennett
• Allison Bennett I
• Carol C. Bennett, LCSW
• Daman Scott Bennett
• James R. Bennett Jr., PA-C
• Linda S Bennett, MPT
• Rachel Elizabeth Bennett, MMS, PA-C
• Robert Todd Bennett, MD
• Sara Bennett, FNP

• Nurse Practitioner in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.