Active NPI
Theresa Delores Bennett, FNP
- Family Nurse Practitioner
- Owego, NY
National Provider Identifier
1497024541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 335938
- Practice address
- 110 Central Ave
Box 70
Owego, NY 13827-1311 - Phone
- (607) 687-5333
- Fax
- (607) 687-4899
- NPI assigned
- Dec 19, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 335938 | NY | Primary |
Addresses
Primary practice location
110 Central Ave
Box 70
Owego, NY 13827-1311
Mailing address
110 Central Ave
Box 70
Owego, NY 13827-1311
Phone (607) 687-5333
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1324252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324252800000",
"number": "1497024541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 CENTRAL AVE",
"address_2": "BOX 70",
"city": "OWEGO",
"state": "NY",
"postal_code": "138271311",
"telephone_number": "607-687-5333",
"fax_number": "607-687-4899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 CENTRAL AVE",
"address_2": "BOX 70",
"city": "OWEGO",
"state": "NY",
"postal_code": "138271311",
"telephone_number": "607-687-5333",
"fax_number": "607-687-4899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "THERESA",
"middle_name": "DELORES",
"name_prefix": "Mrs.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-12-19",
"last_updated": "2011-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "335938",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Owego, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.