Lola Bennett

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

174625 Issued in GA

Practice address

1000 Pelham Pkwy S
Lthhcp
Bronx, NY 10461-1003

Phone

(718) 409-7992

Fax

(718) 904-8320

NPI assigned

Jul 11, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Lola J Benjamin Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1405036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405036800000",
    "number": "1316353238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 CROES AVE",
            "address_2": "B2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104724533",
            "telephone_number": "917-548-7532",
            "fax_number": "718-904-8320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 PELHAM PKWY S",
            "address_2": "LTHHCP",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611003",
            "telephone_number": "718-409-7992",
            "fax_number": "718-904-8320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "LOLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-11",
        "last_updated": "2014-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "405828-1",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "174625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "405828-1",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "174625",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LOLA",
            "last_name": "BENJAMIN",
            "middle_name": "J",
            "credential": "RN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Joan Bennett
• Jocelyn Bennett
• Jules Bennett, M.S., CCC-SLP
• Kimberley Simone Bennett, LPN
• Lisakay Anne Bennett
• Narja Bennett
• Racquel Bennett
• Randi Bennett
• Samantha Bennett
• Shani Bennett, PMHNP-BC

• Registered Nurse in Bronx, NY
• Providers in Bronx, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2014; 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.