Individual provider Active NPI

Jacqueline Bennett

  • Social Worker
  • Clearwater, FL
National Provider Identifier
1558728279
Registry record updated Jan 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
2960 Roosevelt Blvd
Clearwater, FL 33760-1952
Phone
(727) 327-7656
Fax
(727) 322-2110
NPI assigned
Jan 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

2960 Roosevelt Blvd
Clearwater, FL 33760-1952

Mailing address

PO Box 10970
St Petersburg, FL 33733-0970
Phone (727) 327-7656

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": "1453766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1558728279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10970",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337330970",
            "telephone_number": "727-327-7656",
            "fax_number": "727-322-2110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 ROOSEVELT BLVD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337601952",
            "telephone_number": "727-327-7656",
            "fax_number": "727-322-2110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-26",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; 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.