Individual provider Active NPI

Regina Bennett, APN

  • Acute Care Nurse Practitioner
  • Benton, AR
National Provider Identifier
1417333188
Registry record updated Dec 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
A005962 Issued in AR
Practice address
1 Medical Park Dr
Benton, AR 72015-3353
Phone
(501) 574-7130
NPI assigned
Aug 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X A005962 AR Primary

Addresses

Primary practice location

1 Medical Park Dr
Benton, AR 72015-3353

Mailing address

1 Medical Park Dr
Benton, AR 72015-3353
Phone (501) 574-7130

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20190424000629 AR Practitioner - Nurse Practitioner 6406198472 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Inpatient SolutionsGroup PAC ID 5597195206, 31 clinicians

Practice addresses (Care Compare)

5 Medical Park Dr
Suite 304
Benton, AR 72015-3745
Phone (501) 408-2429

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A005962ARMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saline Clinics LLC CurrentSince Mar 3, 2019 Accepting new patients
Inpatient Solutions CurrentSince Jan 1, 2021 Accepting new patients
First Docs LLC CurrentSince Jun 12, 2023 Accepting new patients
Daiya Healthcare PLLC CurrentSince Jan 19, 2023 Accepting new patients
Mercer Bucks Medical Associates, P.C. Past Accepting new patients

Locations

5 Medical Park Dr
Ste 304
Benton, AR 72015
Phone (501) 408-2429

1 Medical Park Dr
Bryant, AR 72015
Phone (501) 776-6000

1636 Higdon Ferry Rd
#301
Hot Springs, AR 71913

1636 Higdon Ferry Rd
Hot Springs National Park, AR 71913
Phone (501) 520-2000

11120 NE 33rd Pl
Ste 202
Bellevue, WA 98004
Phone (206) 426-2584

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16686/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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 1

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": "1438732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544486400000",
    "number": "1417333188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK DR",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720153353",
            "telephone_number": "501-574-7130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK DR",
            "city": "BENTON",
            "state": "AR",
            "postal_code": "720153353",
            "telephone_number": "501-574-7130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "REGINA",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-05",
        "last_updated": "2018-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AR",
            "license": "A005962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton, AR

Sources for this page

Verify at the official NPI Registry.