Individual provider Active NPI

Rachel C. Bennett, M.D.

  • Family Medicine Physician
  • Madison, WI
National Provider Identifier
1497715635
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
55977 Issued in WI
Practice address
1119 Van Buren St
Madison, WI 53711-2223
Phone
(214) 538-0400
NPI assigned
Mar 23, 2006
Reactivated
May 22, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 55977 WI Primary

Addresses

Primary practice location

1119 Van Buren St
Madison, WI 53711-2223

Mailing address

1119 Van Buren St
Madison, WI 53711-2223

Other practice location 1

100 Chesterfield Business Pkwy Ste 200
Chesterfield, MO 63005-1271
Phone (888) 890-2008

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
55977WIMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747872000000",
    "number": "1497715635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1119 VAN BUREN ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537112223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 VAN BUREN ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537112223",
            "telephone_number": "214-538-0400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Chesterfield Business Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MO",
            "postal_code": "630051271",
            "country_code": "US",
            "telephone_number": "888-890-2008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "RACHEL",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2025-05-22",
        "certification_date": "2023-05-16",
        "deactivation_date": "2024-11-20",
        "reactivation_date": "2025-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "55977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.