Nancy Louise Bennett, NP

Key facts

NPI

1366914970

Entity type

Individual (NPI type 1)

Primary specialty

Psychiatric/Mental Health Nurse Practitioner 363LP0808X

License

903080 (MS)

Practice address

712 E Peace St
Canton, MS 39046-4731

Phone

(601) 720-1531

NPI assigned

Dec 20, 2018

Sex

Female

Sole proprietor

No

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.

• Remind Me Wellness Clinic Psychiatric/Mental Health Nurse Practitioner · Canton, MS · NPI 1831926948
  Medicare reassignment NPD Authorized official MS · PSYCHIATRIC/MENTAL HEALTH

Medicare Care Compare profile

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare participation

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 4, 2024.

{
    "created_epoch": "1545264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1366914970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 E OTTO ST",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390464324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 E PEACE ST",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390464731",
            "telephone_number": "601-720-1531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "NANCY",
        "middle_name": "LOUISE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-20",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "903080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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