Individual provider Active NPI

Kimberly Rogers Bennett, FNP-C

  • Family Nurse Practitioner
  • Lynchburg, VA
National Provider Identifier
1477913879
Registry record updated Mar 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024173333 Issued in VA
Practice address
125 Nationwide Dr
Lynchburg, VA 24502-4272
Phone
(434) 200-6933
Fax
(434) 200-6934
NPI assigned
Feb 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024173333 VA Primary

Addresses

Primary practice location

125 Nationwide Dr
Lynchburg, VA 24502-4272

Mailing address

125 Nationwide Dr
Lynchburg, VA 24502-4272
Phone (434) 200-6933

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220118001738 VA Practitioner - Nurse Practitioner 0143612416 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0024173333VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centra Medical Group, LLC CurrentSince Dec 17, 2021 Accepting new patients

Locations

115 Ambriar Plz
Amherst, VA 24521
Phone (434) 381-6090

1901 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 200-3101

125 Nationwide Dr
Lynchburg, VA 24502
Phone (434) 200-3908

1937 Thomson Dr
Lynchburg, VA 24501
Phone (434) 200-6965

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1456444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490659200000",
    "number": "1477913879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 NATIONWIDE DR",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245024272",
            "telephone_number": "434-200-6933",
            "fax_number": "434-200-6934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 NATIONWIDE DR",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245024272",
            "telephone_number": "434-200-6933",
            "fax_number": "434-200-6934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "KIMBERLY",
        "middle_name": "ROGERS",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-26",
        "last_updated": "2017-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024173333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynchburg, VA

Sources for this page

Verify at the official NPI Registry.