Nathaniel D Bennett, PAC

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0110-001867 Issued in VA

Practice address

1970 Roanoke Blvd
Salem, VA 24153-6404

Phone

(540) 982-2463

NPI assigned

Jul 17, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Physicians Emergency Services, Inc.

  • Emergency Medicine Physician
  • Ravenna, OH
  • NPI 1235162942
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405468800000",
    "number": "1427076637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3343 CLARA AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240181301",
            "telephone_number": "540-362-1594",
            "fax_number": "276-236-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 ROANOKE BLVD",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241536404",
            "telephone_number": "540-982-2463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "NATHANIEL",
        "middle_name": "D",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2014-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110-001867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010116309",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luthur Beazley, M.D.
• Cooper Wall Beierle, FNP-C
• Belmont Dialysis LLC (Glenvar Dialysis)
• Lindsay Marie Belue, PHARMD
• Bending Reed Counseling, LLC
• Herbert C Berding Jr., MD
• Sabrina Marie Berger, D.O.
• Teresa Angelique Berry, RN
• Gary Lee Best, O.D.
• Beth Wilson, LLC

• Medical Physician Assistant in Salem, VA
• Providers in Salem, VA by specialty
• Medical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.