Brianna Nicole Bennett

Individual provider Active NPI Personal Care Attendant · Charleston, WV

NPI 1568032472 · NPPES record last updated Jul 1, 2021

Key facts

NPI
1568032472
Entity type
Individual (NPI type 1)
Primary specialty
Personal Care Attendant 3747P1801X
Practice address
1599 2ND Ave
Charleston, WV 25387-2514
Phone
(304) 344-0586
NPI assigned
Jul 1, 2021
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X Yes

Addresses

Primary practice location

1599 2ND Ave
Charleston, WV 25387-2514

Mailing address

PO Box 20112
Charleston, WV 25362-1112

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 1, 2021.

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1568032472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20112",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253621112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1599 2ND AVE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253872514",
            "telephone_number": "304-344-0586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "BRIANNA",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-01",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

All providers in Charleston, WV · Personal Care Attendant in West Virginia

Sources for this page

Verify at the official NPI Registry.