Keaton Bennett, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-09085 Issued in NC

Practice address

1021 Morehead Medical Dr
Ste a
Charlotte, NC 28204-2990

Phone

(980) 442-2000

NPI assigned

Dec 13, 2017

Last updated

Jul 15, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in PA, NC2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Charlotte-Mecklenburg Hospital AuthorityGroup PAC ID 2961310685, 594 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

99

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kbennett690936@carolinashealthcaresystem.direct-ci.com

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.

• The Charlotte-Mecklenburg Hospital Authority

  dba Levine Cancer Institute

  • Medical Oncology Physician
  • Indian Land, SC
  • NPI 1669738829

  NC

  Medicare reassignment Care Compare group
• St. Luke's Hosptial

  dba St. Luke's Care Now - Wind Gap

  • Urgent Care Clinic/Center
  • Wind Gap, PA
  • NPI 1376965731
  Medicare reassignment NPD
• Carolinas Medical Center

  dba Atrium Health Levine Children's Gastroenterology

  • Obstetrics & Gynecology Physician
  • Charlotte, NC
  • NPI 1275774333
  Medicare reassignment
• Carolinas Physicians Network Inc

  dba Atrium Health Musculoskeletal Institute Orthopedics & Sports Medici

  • Orthopaedic Surgery Physician
  • Charlotte, NC
  • NPI 1437607686
  Medicare reassignment
• St. Luke's Hospital

  dba St. Luke's Care Now - Bethlehem

  • Urgent Care Clinic/Center
  • Bethlehem, PA
  • NPI 1740232719
  Medicare reassignment
• St. Luke's Hospital Monroe Campus

  • Occupational Medicine Physician
  • Stroudsburg, PA
  • NPI 1609311257
  Medicare reassignment
• St. Luke's Physician Group, Inc.

  dba South Mountain Family Practice

  • Family Medicine Physician
  • Bethlehem, PA
  • NPI 1700984622
  Medicare reassignment
• St. Luke's Quakertown Hospital

  dba St. Luke's Quakertown Hospital - Pathology

  • Anatomic Pathology & Clinical Pathology Physician
  • Quakertown, PA
  • NPI 1225052616
  Medicare reassignment
• The Carbon-Schuylkill Community Hospital, Inc.

  dba St. Luke's Miners Memorial Hospital ER

  • Emergency Medicine Physician
  • Coaldale, PA
  • NPI 1194891010
  Medicare reassignment
• Carolinas Medical Center

  dba Atrium Health Pharmacy Kenilworth

  • Community/Retail Pharmacy
  • Charlotte, NC
  • NPI 1982710554
  NPD
• Carolinas Pathology Group, PA

  dba Carolinas Pathology Group

  • Specialist
  • Charlotte, NC
  • NPI 1689628158
  NPD
• Carolinas Physicians Network Inc

  dba Atrium Health Diabetes Prevention

  • Endocrinology, Diabetes & Metabolism Physician
  • Charlotte, NC
  • NPI 1437038544
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Carolinas Medical Center

  dba Atrium Health Behavioral Health

  • Psychiatric Hospital Unit
  • Charlotte, NC
  • NPI 1053358945
  Care Compare affiliation
• Carolinas Medical Center

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1295789907
  Care Compare affiliation
• Carolinas Medical Center

  dba Atrium Health Mercy

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1376985135
  Care Compare affiliation
• Carolinas Medical Center

  dba Levine Children's Hospital Pediatrics

  • Children's Rehabilitation Hospital
  • Charlotte, NC
  • NPI 1699829887
  Care Compare affiliation
• Carolinas Medical Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Charlotte, NC
  • NPI 1720029705

  Hospital

  Care Compare affiliation
• Carolinas Medical Center

  dba Atrium Health Laboratory

  • Clinical Medical Laboratory
  • Charlotte, NC
  • NPI 1811005150

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1513123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1265947279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 MOREHEAD MEDICAL DR",
            "address_2": "STE A",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282042990",
            "telephone_number": "980-442-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 Medical Park Dr",
            "address_2": "Ste 202",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280251902",
            "country_code": "US",
            "telephone_number": "704-403-1911",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10660 Park Rd",
            "address_2": "Ste 4500",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108413",
            "country_code": "US",
            "telephone_number": "704-667-8800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1437 Scott Ave",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035843",
            "country_code": "US",
            "telephone_number": "704-446-1900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1010 Edgehill Rd N",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282071885",
            "country_code": "US",
            "telephone_number": "704-446-1900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "KEATON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-13",
        "last_updated": "2024-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-09085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbennett690936@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1021 Morehead Medical Dr",
            "address_2": "Ste A",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282042990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jeremy Michael Bennett, MD
• Joan M. Bennett, CRNA
• Kassandra Jean Bennett, PA
• Katie Jeter Bennett, MD
• Kayleigh Hudson Bennett, PA
• Keturah Bennett
• Latyeasaral Monquella Bennett, N.P.
• Lauren Ashley Collins Bennett, CRNA
• Leo Bennett
• Luke Andrew Bennett, D.C.

• Physician Assistant in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.