Douglas Ryan Bennett, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

1090 Issued in NC

Practice address

1400 Edwards Mill Rd
Raleigh, NC 27607-3624

Phone

(919) 861-2308

NPI assigned

Jul 26, 2006

Last updated

Jul 30, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1386668317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 EDWARDS MILL RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276073624",
            "telephone_number": "919-412-5466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 EDWARDS MILL RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276073624",
            "telephone_number": "919-861-2308"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Competition Center Dr",
            "address_purpose": "LOCATION",
            "city": "Morrisville",
            "state": "NC",
            "postal_code": "275609034",
            "country_code": "US",
            "telephone_number": "919-861-2308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "DOUGLAS",
        "middle_name": "RYAN",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "1090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam J Bennett, MD
• Anna Kristine Bennett, CRNP, PMHNP-BC
• Brian Charles Bennett, M.D.
• Brianna Kay Bennett
• Daniel Kittelle Bennett, MD
• Holly Adams Bennett, O.D.
• Jacquelyn Bennett, PHARMD
• Jeffrey A Bennett
• Jennifer Bennett, CCC-SLP, NC BOESLP
• Judy Neal Bennett, RPH

• Athletic Trainer in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Athletic Trainer in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; 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.