Grant D. Bennett

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

GRANT D. BENNETT

Practice address

6223 Clark Rd.
Blackshear, GA 31516

Phone

(912) 807-6625

Fax

(912) 807-0212

NPI assigned

May 16, 2008

Organization subpart

No

Name

Grant D. BennettNPI 1164691267

Title

Owner/Manager/Technician

Phone

(912) 614-2269

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Grant Douglas Bennett

  • Durable Medical Equipment & Medical Supplies
  • Blackshear, GA
  • NPI 1164691267
  NPD (past) Authorized official

• Bennett Mobility Products Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 25, 2019.

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556150400000",
    "number": "1376700401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6223 CLARK RD.",
            "city": "BLACKSHEAR",
            "state": "GA",
            "postal_code": "31516",
            "telephone_number": "912-807-6625",
            "fax_number": "912-807-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6223 CLARK RD.",
            "city": "BLACKSHEAR",
            "state": "GA",
            "postal_code": "31516",
            "telephone_number": "912-807-6625",
            "fax_number": "912-807-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANT D. BENNETT",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-16",
        "last_updated": "2019-04-25",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "GRANT",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER/MANAGER/TECHNICIAN",
        "authorized_official_telephone_number": "912-614-2269"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003108583A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "879144878A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bennett Mobility Products",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Bennett Mobility Products",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Garden View Retirement Assisted Living
• Gardi Drug Company, LLC
• Georgia Physician South,PC
• Georgia Physicians South, PC
• Allison Barnwell Graham
• Harborview Waycross, LLC
• Travis Ray Harrison, PHARM D
• Courtney L Hayes, FNP
• Erin Hodges, NP
• Kim Bradley Hood, DMD PC

• All providers in Blackshear, GA
• Durable Medical Equipment & Medical Supplies in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; 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.