Active NPI
Rocelious Marquis Bennett
- Body Imaging Physician
- Moreno Valley, CA
National Provider Identifier
1518167253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Body Imaging Physician
- License
- RHT86834
- Practice address
- 13550 Wilmot St
Moreno Valley, CA 92555-8233 - Phone
- (909) 815-5881
- NPI assigned
- Jul 20, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Body Imaging Physician | 2085B0100X | RHT86834 | CA | Primary |
Addresses
Primary practice location
13550 Wilmot St
Moreno Valley, CA 92555-8233
Mailing address
13550 Wilmot St
Moreno Valley, CA 92555-8233
Phone (909) 815-5881
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RHT86834 | CA | MD | Body Imaging Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184889600000",
"number": "1518167253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13550 WILMOT ST",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925558233",
"telephone_number": "909-815-5881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13550 WILMOT ST",
"city": "MORENO VALLEY",
"state": "CA",
"postal_code": "925558233",
"telephone_number": "909-815-5881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "ROCELIOUS",
"middle_name": "MARQUIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-20",
"last_updated": "2007-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "2085B0100X",
"taxonomy_group": "",
"desc": "Radiology, Body Imaging",
"state": "CA",
"license": "RHT86834",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moreno Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.