Kim D Bennett, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

1988 Issued in WV

Practice address

252 Rural Acres Dr
Beckley, WV 25801-3503

Phone

(304) 252-8551

Fax

(304) 252-1790

NPI assigned

Sep 29, 2006

Last updated

Jan 12, 2025By 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

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kim.bennett.1@14333.direct.athenahealth.com
• Direct secure messaging: kim.bennett@wvafn.hcadirect.net

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.

• Community Health Systems, Inc.

  dba Access Health

  • Federally Qualified Health Center (FQHC)
  • Beckley, WV
  • NPI 1588738538
  Medicare reassignment NPD
• Community Health Systems Inc

  dba AccessHealth Professional Park 2

  • Federally Qualified Health Center (FQHC)
  • Beckley, WV
  • NPI 1194510644
  NPD

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736640000000",
    "number": "1295827814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 RURAL ACRES DR",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013503",
            "telephone_number": "304-252-8551",
            "fax_number": "304-252-1790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 RURAL ACRES DR",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258013503",
            "telephone_number": "304-252-8551",
            "fax_number": "304-252-1790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "KIM",
        "middle_name": "D",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2025-01-12",
        "certification_date": "2025-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "1988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "58941",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARELINK",
            "identifier": "321488",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "H90133",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "001722123",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3004166000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE",
            "identifier": "2145382",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54878",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marcia Beller, LPC, NCC, ADC
• Brenda F Belmont
• Sarah Benfield
• Carissa Ann Bennett, NP-C
• Kelli Denise Bennett
• Leah Dionne Bennett
• Lisa G Bennett, FNP
• Scott William Berneburg, DPM
• Rio Calvez Bero, OTR/L
• Braxton Berry

• Pediatrics Physician in Beckley, WV
• Providers in Beckley, WV by specialty
• Pediatrics Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2025; 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.