Brett R Bennion, MD, PC
Organization Active NPI Specialist · Sidney, MT
NPI 1487782322 · NPPES record last updated Nov 13, 2020
Key facts
- NPI
- 1487782322
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- 8624 (MT)
- Legal business name
- BRETT R BENNION, MD, PC
- Practice address
- 214 14TH Ave SW Ste 101
Sidney, MT 59270-3521 - Phone
- (406) 488-2380
- Fax
- (406) 488-2382
- NPI assigned
- Mar 1, 2007
- Organization subpart
- No
Authorized official
- Name
- Brett Bennion, MD
- Title
- Owner
- Phone
- (406) 488-2380
Practitioners 4
-
Patricia E Cantrell, PAC
-
Kaci L Dean, APRN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041101001000 | MT | Part B Supplier - Clinic/Group Practice | 2365403060 |
Receives reassigned benefits from 2 practitioners Practice locations: Sidney, MT |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | 8624 | MT | Yes |
Addresses
Primary practice location
214 14TH Ave SW Ste 101
Sidney, MT 59270-3521
Mailing address
214 14TH Ave SW Ste 101
Sidney, MT 59270-3521
Phone (406) 488-2380
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000084277 | Other | MEDICARE GROUP # | |
| 0015759 | Medicaid | MT | |
| 10976 | Medicaid | ND | |
| 18595 | Other | ND | BLUE CROSS |
| 000018941 | Other | MT | BLUE CROSS |
| N711308 | Other | MEDICARE LEGACY |
Other providers in Sidney, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 13, 2020. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.