Todd P Bennett, MD
Individual provider Active NPI Emergency Medicine Physician · Front Royal, VA
NPI 1396763009 · NPPES record last updated Nov 25, 2024
Key facts
- NPI
- 1396763009
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 0101237797 (VA)
- Practice address
- 1000 N Shenandoah Ave
Front Royal, VA 22630-3547 - Phone
- (540) 636-0327
- Fax
- (540) 636-0189
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- JC Edwards School of Medicine, Marshall University, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Grant Memorial Hospital Inc
Practice addresses (Care Compare)
117 Hospital Dr
Petersburg, WV 26847-9566
Phone (304) 257-1026
Hospital & facility affiliations
- Grant Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WV, VA
- 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 |
|---|---|---|---|---|
| I20050209000065 | WV | Practitioner - Emergency Medicine | 4082665807 | Reassigns benefits to 3 organizations |
| I20050707000760 | VA | Practitioner - Emergency Medicine | 4082665807 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18600 | WV | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Warren Memorial Hospital, Inc. | Current |
Accepting new patients | |
| Warren Memorial Hospital, Inc. | Emergency Medicine | Current |
Accepting new patients |
| Health Care Alliance, Inc. | Emergency Medicine | Current |
Accepting new patients |
| Grant Memorial Hospital Inc | Current |
Accepting new patients | |
| Grant Memorial Hospital Inc | Current |
Accepting new patients | |
| Warren Memorial Hospital, Inc. | Past | Accepting new patients | |
| Bestpractices of West Virginia, Inc. | Emergency Medicine | Past | Accepting new patients |
Locations
351 Valley Health Way
Front Royal, VA 22630
Phone (540) 636-0300
1000 N Shenandoah Ave
Front Royal, VA 22630
Phone (540) 636-0300
200 Memorial Dr
Luray, VA 22835
Phone (540) 743-4561
759 S Main St
Woodstock, VA 22664
Phone (540) 459-1100
1710 Harper Rd
Beckley, WV 25801
Phone (304) 252-0641
20 Hospital Dr
Logan, WV 25601
Phone (304) 792-1101
1824 Murdoch Ave
Parkersburg, WV 26101
Phone (304) 424-4057
117 Hospital Dr
Petersburg, WV 26847
Phone 30497450009312
Interoperability endpoints
- pbennett124509@soc.inova.org
- tbennett124509@valleyhealth.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 18600 | WV | |
| Emergency Medicine Physician | 207P00000X | 0101237797 | VA | Yes |
Addresses
Primary practice location
1000 N Shenandoah Ave
Front Royal, VA 22630-3547
Mailing address
1000 N Shenandoah Ave
Front Royal, VA 22630-3547
Phone (540) 636-0327
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010288266 | Medicaid | VA |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | pbennett124509@soc.inova.org |
Other providers in Front Royal, VA
- Jennifer Browning Barron
- Michelle Beamer
- Amanda Becker
- Belle Grove Physician Services, LLC
- Benchmark Physical Therapy of VA, LLC
- Berman Family Chiropractic, Inc.
- Scott Jason Berman
- Elizabeth Berry
- Andrea J Bieber
- Kathleen Marie Black
All providers in Front Royal, VA · Emergency Medicine Physician in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 25, 2024. 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.