Individual provider Active NPI

Jon Michael Bennett, DO

  • Anesthesiology Physician
  • Myrtle Beach, SC
National Provider Identifier
1366427841
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
37755 Issued in SC
Practice address
7900 N Kings Hwy
Myrtle Beach, SC 29572-3055
Phone
(843) 449-3381
Fax
(843) 449-9721
NPI assigned
Dec 7, 2005
Last updated
Oct 10, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 37755 SC Primary

Addresses

Primary practice location

7900 N Kings Hwy
Myrtle Beach, SC 29572-3055

Mailing address

7900 N Kings Hwy
Myrtle Beach, SC 29572-3055
Phone (843) 449-3381

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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

Enrollment IDStateProvider typePAC IDDetails
I20160122000769 SC Practitioner - Anesthesiology 7618921685 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Western University of Health Sciences College of Dental Med, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstream Anesthesia PLLCGroup PAC ID 7416198049, 571 clinicians

Practice addresses (Care Compare)

391 Serpentine Dr
Suite 200
Spartanburg, SC 29303-3079
Phone (864) 585-2002

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7453CAMDAddiction (Substance Use Disorder) Counselor
37755SCMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florence Surgery & Laser Center LLC CurrentSince Jul 1, 2016 Accepting new patients
York County Anesthesia Associates LLC Anesthesiology CurrentSince May 15, 2016 Accepting new patients
Medstream Anesthesia PLLC Anesthesiology CurrentSince Apr 4, 2023 Accepting new patients
Strand Gi Associates PA Anesthesiology CurrentSince Nov 8, 2023 Accepting new patients
Florence Surgery & Laser Center LLC CurrentSince Jul 1, 2016 Accepting new patients
Atlantic Coast Anesthesia Services P.C. Anesthesiology CurrentSince Jun 1, 2020 Accepting new patients
Gary Chinghuei Kao MD Inc Anesthesiology Past Accepting new patients
Anesthesia Network Services, LLC Anesthesiology Past Accepting new patients

Locations

4901 Dawn Dr
Ste 1100
Lumberton, NC 28360
Phone (910) 887-2361

400 N Cashua Dr
Florence, SC 29501
Phone (843) 664-9398

606 Black River Rd
Georgetown, SC 29440
Phone (843) 527-7000

4070 Highway 17
Murrells Inlt, SC 29576
Phone (843) 357-5100

1021 Cipriana Dr
Ste 100
Myrtle Beach, SC 29572
Phone (843) 449-7885

2200 Crow Ln
Ste 102
Myrtle Beach, SC 29577
Phone (843) 520-8217

7900 N Kings Hwy
Myrtle Beach, SC 29572
Phone (843) 449-3381

2669 Kinard St
Newberry, SC 29108
Phone (803) 276-7570

164 Glenwood Dr
Rock Hill, SC 29732
Phone (803) 325-9010

391 Serpentine Dr
Ste 200
Spartanburg, SC 29303
Phone (864) 583-6381

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1366427841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 N KINGS HWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295723055",
            "telephone_number": "843-449-3381",
            "fax_number": "843-449-9721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 N KINGS HWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295723055",
            "telephone_number": "843-449-3381",
            "fax_number": "843-449-9721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "JON",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SC",
            "license": "37755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

Verify at the official NPI Registry.