Active NPI
Lunawati Lo Bennett
- Pharmacist
- Jackson, TN
National Provider Identifier
1235730680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0000036711
- Practice address
- 1050 Union University Dr
Jackson, TN 38305-3697 - Phone
- (561) 420-9471
- NPI assigned
- Nov 3, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0000036711 | TN | Primary |
Addresses
Primary practice location
1050 Union University Dr
Jackson, TN 38305-3697
Mailing address
1050 Union University Dr
Jackson, TN 38305-3697
Phone (561) 420-9471
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PHARMACIST | Other | TN | PHARMACIST |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Jackson | Direct |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000036711 | TN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Union University | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604361600000",
"number": "1235730680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1050 UNION UNIVERSITY DR",
"city": "JACKSON",
"state": "TN",
"postal_code": "383053697",
"telephone_number": "561-420-9471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 UNION UNIVERSITY DR",
"city": "JACKSON",
"state": "TN",
"postal_code": "383053697",
"telephone_number": "561-420-9471"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "LUNAWATI",
"middle_name": "LO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-03",
"last_updated": "2020-11-03",
"certification_date": "2020-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "0000036711",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST",
"identifier": "PHARMACIST",
"state": "TN"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Jackson",
"affiliation": "N",
"endpointDescription": "pharmacist",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Jackson",
"address_1": "1050 Union University Dr",
"city": "Jackson",
"state": "TN",
"country_code": "US",
"postal_code": "383053697",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Jackson, TN
- Stacey Bell, M.S.
- Erin Bellinger, B.S.
- Deborah Ann Bellinghausen, MSW
- Bemis Medical Clinic, Inc. (Bemis Medical Clinic,inc II)
- Fred A Benjamin IV, CRNA
- Stephen G Bergquist, MD
- Ashley Erin Berkley, PHARM D
- Samantha Lynn Berkley, PHARM D.
- Blaire Alexandria Berry-Young, LPN
- Joy Marie Berry, CASE MANAGER
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.