Individual provider Active NPI

Stephanie J Bennett, ARNP

  • Family Nurse Practitioner
  • College Place, WA
National Provider Identifier
1376536706
Registry record updated Oct 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP30005581 Issued in WA
Practice address
295 South College Ave. Suite 1
College Place, WA 99324
Phone
(509) 382-8349
Fax
(509) 593-4342
NPI assigned
Aug 31, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP30005581 WA
Family Nurse Practitioner 363LF0000X AP30005581 WA Primary

Addresses

Primary practice location

295 South College Ave. Suite 1
College Place, WA 99324

Mailing address

1012 South Third Street
Dayton, WA 99328
Phone (503) 413-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100901000049 WA Practitioner - Nurse Practitioner 6002930823 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Washington University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia County Hospital District 55 clinicians

Practice addresses (Care Compare)

1012 S 3Rd St
Dayton, WA 99328-1606
Phone (509) 382-2531

Hospital & facility affiliations

  • Dayton General Hospital Hospital, Dayton, WA, CCN 501302
  • Providence St Mary Medical Center Hospital, Walla Walla, WA, CCN 500002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Salmon Creek Hospital CurrentSince Apr 1, 2018 Accepting new patients
Columbia County Hospital District CurrentSince Aug 15, 2022 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Apr 1, 2018 Accepting new patients
Columbia County Hospital District CurrentSince Aug 15, 2022 Accepting new patients
Columbia County Hospital District Past Accepting new patients

Locations

295 S College Ave
#1
College Place, WA 99324
Phone (509) 382-2531

1012 S 3rd St
Dayton, WA 99328
Phone (509) 382-2531

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

1000 SE Tech Center Dr
Ste 120
Vancouver, WA 98683
Phone (360) 260-2773

1000 SE Tech Center Dr
Vancouver, WA 98683
Phone (360) 260-2273

Organizations & group practices 8

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1376536706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 SOUTH THIRD STREET",
            "city": "DAYTON",
            "state": "WA",
            "postal_code": "99328",
            "telephone_number": "503-413-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 SOUTH COLLEGE AVE. SUITE 1",
            "city": "COLLEGE PLACE",
            "state": "WA",
            "postal_code": "99324",
            "telephone_number": "509-382-8349",
            "fax_number": "509-593-4342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "STEPHANIE",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-31",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30005581",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30005581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Place, WA

Sources for this page

Verify at the official NPI Registry.