Sondra Michelle Bennett, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

859958 Issued in MS

Practice address

2434 S Eason Blvd
Tupelo, MS 38804-6942

Phone

(662) 844-1717

Fax

(662) 680-6416

NPI assigned

May 23, 2013

Last updated

Aug 7, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Mental Health-Mental Retardation CommissionGroup PAC ID 5193611747, 10 clinicians

Practice addresses (Care Compare)

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.

• Northeast Mental Health-Mental Retardation Commission

  dba Lifecore Health Group

  • Rural Health Clinic/Center
  • Tupelo, MS
  • NPI 1548413628
  Medicare reassignment Care Compare group NPD
• Sondra Bennett Pmhnp-BC LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Tupelo, MS
  • NPI 1710532668
  Authorized official Same address or phone
• Right Track Medical Group, Inc

  • Psychiatry Physician
  • Olive Branch, MS
  • NPI 1972080257
  NPD (past)

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

{
    "created_epoch": "1369267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565136000000",
    "number": "1275970725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 S THOMAS ST STE 207",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388015337",
            "telephone_number": "662-205-6905",
            "fax_number": "662-269-6722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2434 S EASON BLVD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388046942",
            "telephone_number": "662-844-1717",
            "fax_number": "662-680-6416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "SONDRA",
        "middle_name": "MICHELLE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-23",
        "last_updated": "2019-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "859958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael R Benge, CRNA
• Mohamed Abdulhamid Benhammuda, MD
• David Bennett
• Gregory Allen Bennett
• Olivia Bennett, FNP-BC
• Brock Benson
• Jeanne R Benson, CFNP
• Tami Berrios, RN
• Berry NP Services (True Care Family Medical Clinic)
• James Montgomery Berry, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Psychiatric/Mental Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; 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.