Laura Bennett, APN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP029186 Issued in PA

Practice address

1700 N Broad St Ste 4
Philadelphia, PA 19121-3429

Phone

(215) 204-7500

NPI assigned

Feb 4, 2014

Last updated

Mar 21, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Laura Wagner Former name

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Advocare, LLC

  • Pediatrics Physician
  • Marlton, NJ
  • NPI 1770538696
  Medicare reassignment NPD
• Advocare , LLC

  dba Advocare Berlin Medical Associates (DME)

  • Internal Medicine Physician
  • Manahawkin, NJ
  • NPI 1912762162
  NPD
• Temple University of the Commonwealth System of Higher Education

  dba Temple University Kornberg School of Dentistry OS

  • Oral and Maxillofacial Surgery (Dentist)
  • Philadelphia, PA
  • NPI 1912687187
  NPD (past)
• Chop Clinical Associates, Inc

  dba CHOP Primary Care Moorestown

  • Pediatrics Physician
  • Moorestown, NJ
  • NPI 1891870432
  NPD (past)
• Chop Clinical Associates, Inc.

  dba Care Network Smithville

  • Pediatrics Physician
  • Smithville, NJ
  • NPI 1669552451
  NPD (past)
• The Children's Hospital of Philadelphia

  • Primary Care Clinic/Center
  • Mount Laurel, NJ
  • NPI 1295192193
  NPD (past)

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

{
    "created_epoch": "1391472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1245654771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 HENFIELD AVE",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080031549",
            "telephone_number": "609-540-7207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 N BROAD ST STE 4",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191213429",
            "telephone_number": "215-204-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13 S Lakeview Dr",
            "address_purpose": "LOCATION",
            "city": "Gibbsboro",
            "state": "NJ",
            "postal_code": "080261155",
            "country_code": "US",
            "telephone_number": "856-783-2802",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Marter Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Moorestown",
            "state": "NJ",
            "postal_code": "080573147",
            "country_code": "US",
            "telephone_number": "856-235-2147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "LAURA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-04",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00482500",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00482500",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP029186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "WAGNER",
            "credential": "APN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth N Bennett, CRNP
• Frederick Christian Bennett, MD
• George R Bennett, OD
• Jajuan Bennett
• Kevin Donnell Bennett, LCSW
• Mariko Bennett, MD, PHD
• Michael J Bennett, PH.D.
• Nadia L Bennett, MD
• Nia Bennett, LPN
• Nicholas Nathaniel Bennett

• Family Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.