Marvin Stephone Bennett

Primary specialty

DriverTaxonomy code 172A00000X

License

T62974258 Issued in VA

Practice address

4825 Suecla Dr
Richmond, VA 23231-2921

Phone

(804) 475-0795

Fax

(804) 226-7998

NPI assigned

Sep 25, 2017

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 25, 2017.

{
    "created_epoch": "1506297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506297600000",
    "number": "1245749035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4825 SUECLA DR",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232312921",
            "telephone_number": "804-226-7998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4825 SUECLA DR",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232312921",
            "telephone_number": "804-475-0795",
            "fax_number": "804-226-7998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "MARVIN",
        "middle_name": "STEPHONE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-25",
        "last_updated": "2017-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": "VA",
            "license": "T62974258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James P. Bennett Jr., M.D.
• Joel Alan Bennett, M.D.
• Jonathan David Bennett, M.D.
• Lillie Robinson Bennett, MD
• Lisa Bennett, MD
• Mary Keely Costello Bennett, AGACNP-BC
• Richard Leroy Bennett Jr., MD
• Ines Benothmane, DPT
• Halimah Bakir Benson, LPN
• Kristen Frances Benson

• All providers in Richmond, VA
• Driver in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2017; 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.