Individual provider Active NPI

Anna M Bennett, CST

  • Surgical Assistant
  • Minnetonka, MN
National Provider Identifier
1265779714
Registry record updated Jan 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
License
127229 Issued in MN
Practice address
14001 Ridgedale Dr
Suite 200
Minnetonka, MN 55305-1753
Phone
(952) 249-2000
Fax
(952) 249-2099
NPI assigned
Jan 3, 2013
Last updated
Jan 3, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X 127229 MN Primary

Addresses

Primary practice location

14001 Ridgedale Dr
Suite 200
Minnetonka, MN 55305-1753

Mailing address

14001 Ridgedale Dr
Suite 200
Minnetonka, MN 55305-1753
Phone (952) 249-2000

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

LicenseStateTypeSpecialty
127229MNMDSurgical Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Obstetrics & Gynecology Past Accepting new patients
Premier OBGYN of Minnesota PLLC PastSince Jan 1, 2011 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1357171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357171200000",
    "number": "1265779714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14001 RIDGEDALE DR",
            "address_2": "SUITE 200",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051753",
            "telephone_number": "952-249-2000",
            "fax_number": "952-249-2099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14001 RIDGEDALE DR",
            "address_2": "SUITE 200",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051753",
            "telephone_number": "952-249-2000",
            "fax_number": "952-249-2099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "ANNA",
        "middle_name": "M",
        "credential": "CST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-03",
        "last_updated": "2013-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "MN",
            "license": "127229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; 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.