Individual provider Active NPI

William R Bennett, MD

  • Interventional Cardiology Physician
  • Spokane, WA
National Provider Identifier
1396791026
Registry record updated May 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
MD00023687 Issued in WA
Practice address
122 W 7TH Ave
Suite 310
Spokane, WA 99204-2349
Phone
(509) 838-7711
Fax
(509) 747-4664
NPI assigned
May 25, 2006
Last updated
May 23, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2017

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X M5621 ID
Cardiovascular Disease Physician 207RC0000X MD23687 WA
Interventional Cardiology Physician 207RI0011X M5621 ID
Interventional Cardiology Physician 207RI0011X MD00023687 WA Primary

Addresses

Primary practice location

122 W 7TH Ave
Suite 310
Spokane, WA 99204-2349

Mailing address

122 W 7TH Ave
Suite 310
Spokane, WA 99204-2349
Phone (509) 838-7711

Other identifiers 3

IdentifierTypeStateIssuer
003212700MedicaidID
MD23687OtherWALICENSE
M5621OtherIDLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, ID2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040511000804 WA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 2668461922 Reassigns benefits to 1 organization
I20050318000702 ID Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 2668461922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)
Education
University of Louisville School of Medicine, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

311 S L St
Tacoma, WA 98405-3720

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

910 W 5TH Ave
Suite 900
Spokane, WA 99204-2948
Phone (509) 755-5500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M5621IDMDCardiovascular Disease Physician
MD23687WAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Aug 17, 2020 Accepting new patients
Multicare Health System CurrentSince Aug 17, 2020 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Aug 17, 2020 Accepting new patients
Northwest Cardiac and Vascular Imaging, LLC PastSince Nov 1, 2004 Accepting new patients
Spokane Valley Family Medicine P.S. Past Accepting new patients

Locations

980 W Ironwood Dr
Ste 205
Coeur D Alene, ID 83814
Phone (208) 765-2610

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

800 W 5th Ave
Spokane, WA 99204
Phone (509) 458-5800

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Interoperability endpoints

  • Direct secure messaging: wbennett492959@direct.multicare.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495497600000",
    "number": "1396791026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 W 7TH AVE",
            "address_2": "SUITE 310",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042349",
            "telephone_number": "509-838-7711",
            "fax_number": "509-747-4664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 W 7TH AVE",
            "address_2": "SUITE 310",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042349",
            "telephone_number": "509-838-7711",
            "fax_number": "509-747-4664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "WILLIAM",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2017-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ID",
            "license": "M5621",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": "MD23687",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "ID",
            "license": "M5621",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "WA",
            "license": "MD00023687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003212700",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "MD23687",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "M5621",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.