Charles D Bennett, LPN

Individual provider Active NPI Licensed Practical Nurse · Circleville, OH

NPI 1508501412 · NPPES record last updated May 4, 2022

Key facts

NPI
1508501412
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
LPN.124587.MEDS-IV (OH)
Practice address
2065 Stoneridge Dr
Circleville, OH 43113-8956
Phone
(740) 500-1391
NPI assigned
May 4, 2022
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LPN.124587.MEDS-IVOHMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Full Circle Recovery of Circleville Current
since May 8, 2022
Accepting new patients
Full Circle Recovery of Circleville Current
since May 8, 2022
Accepting new patients

Locations

2065 Stoneridge Dr
Circleville, OH 43113
Phone (740) 500-1391

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/hopevalleyrecovery/r4/

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN.124587.MEDS-IV OH Yes

Addresses

Primary practice location

2065 Stoneridge Dr
Circleville, OH 43113-8956

Mailing address

2065 Stoneridge Dr
Circleville, OH 43113-8956
Phone (740) 500-1391

Other providers in Circleville, OH

All providers in Circleville, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.