Jon Michael Bennett, DO
Individual provider Active NPI Anesthesiology Physician · Myrtle Beach, SC
NPI 1366427841 · NPPES record last updated Oct 10, 2023
Key facts
- NPI
- 1366427841
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- 37755 (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
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Medicare Care Compare profile
- 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 PLLC
Practice addresses (Care Compare)
391 Serpentine Dr
Suite 200
Spartanburg, SC 29303-3079
Phone (864) 585-2002
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160122000769 | SC | Practitioner - Anesthesiology | 7618921685 | Reassigns benefits to 6 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37755 | SC | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Strand Gi Associates PA | Anesthesiology | Current |
Accepting new patients |
| Florence Surgery & Laser Center LLC | Current |
Accepting new patients | |
| Florence Surgery & Laser Center LLC | Current |
Accepting new patients | |
| Atlantic Coast Anesthesia Services P.C. | Anesthesiology | Current |
Accepting new patients |
| York County Anesthesia Associates LLC | Anesthesiology | Current |
Accepting new patients |
| Medstream Anesthesia PLLC | Anesthesiology | Current |
Accepting new patients |
| Anesthesia Network Services, LLC | Anesthesiology | Past | Accepting new patients |
| Gary Chinghuei Kao MD Inc | 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
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
1021 Cipriana Dr
Ste 100
Myrtle Beach, SC 29572
Phone (843) 449-7885
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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 37755 | SC | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00AX74530 | Medicaid | CA |
Other providers in Myrtle Beach, SC
- Antonio Benevento
- Benjamin J Bittner OD Inc
- Jeff A Benjamin
- Austin Hunter Bennett
- Bralyn Bennett Jr.
- Jonathan Antonio Bennett Jr.
- Micah Raven Bennett
- Abbey Bensing
- Erika Benson-Levy
- Brandi Watts Benson
All providers in Myrtle Beach, SC · Anesthesiology Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.