Mark Barry Bennett, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LMSW-31056 Issued in ID

Practice address

2275 W Broadway St
Ste G
Idaho Falls, ID 83402-2902

Phone

(208) 524-7400

Fax

(208) 524-8004

NPI assigned

Oct 1, 2013

Last updated

Oct 1, 2013By the provider in NPPES

Sex

Male

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 ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Mark Bennett PLLC

  • Clinical Social Worker
  • Idaho Falls, ID
  • NPI 1285396481
  Medicare reassignment NPD Authorized official
• High Country Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Idaho Falls, ID
  • NPI 1295379865
  Medicare reassignment NPD
• High Country Behavioral Health

  • Mental Illness Community Based Residential Treatment Facility
  • Douglas, WY
  • NPI 1750113882
  NPD

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

{
    "created_epoch": "1380585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380585600000",
    "number": "1306273784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2275 W BROADWAY ST",
            "address_2": "STE G",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834022902",
            "telephone_number": "208-524-7400",
            "fax_number": "208-524-8004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 W BROADWAY ST",
            "address_2": "STE G",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834022902",
            "telephone_number": "208-524-7400",
            "fax_number": "208-524-8004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "MARK",
        "middle_name": "BARRY",
        "name_prefix": "Mr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-10-01",
        "last_updated": "2013-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LMSW-31056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barry Bennett, MD
• Braden Bennett, PT, DPT
• Eric Bennett, M.D.
• Laurren Ashley Bennett, PA-C
• Maialisa Bennett
• Ashley Benson, LCSW
• Elsa Marie Benson, LMSW
• Richard Whiting Bentley, M.D.
• Matlyn Bentz, COTA/L
• Elizabeth Ann Berger, NP

• Social Worker in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2013; 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.