Individual provider Active NPI

Jane Ann Bennett-Munro, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Twin Falls, ID
National Provider Identifier
1356393631
Registry record updated Nov 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
M3734 Issued in ID
Practice address
650 Addison Ave W
Twin Falls, ID 83303-0409
Phone
(208) 737-2035
NPI assigned
May 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X M3734 ID Primary

Addresses

Primary practice location

650 Addison Ave W
Twin Falls, ID 83303-0409

Mailing address

PO Box 553
Twin Falls, ID 83303-0553

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M3734IDMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Magic Valley Regional Medical Center LTD Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289952000000",
    "number": "1356393631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 553",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833030553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 ADDISON AVE W",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833030409",
            "telephone_number": "208-737-2035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT-MUNRO",
        "first_name": "JANE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2010-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "ID",
            "license": "M3734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2010; 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.