Individual provider Active NPI

Reggie Bennett, CAA

  • Anesthesiologist Assistant
  • Reidsville, GA
National Provider Identifier
1568240307
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
789789989 Issued in GA
Practice address
247 S Main St
Reidsville, GA 30453-4605
Phone
(912) 557-1000
NPI assigned
Sep 21, 2023
Last updated
Aug 24, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 789789989 GA Primary

Addresses

Primary practice location

247 S Main St
Reidsville, GA 30453-4605

Mailing address

4616 Tuten Dr
Bristol, GA 31518-3206
Phone (912) 424-0538

Other practice location 1

800 Prudential Dr
Jacksonville, FL 32207-8202
Phone (904) 202-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231023000023 FL Practitioner - Anesthesiology Assistant 5395191746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
US Anesthesia Partners of Florida IncGroup PAC ID 0345143152, 1,111 clinicians

Practice addresses (Care Compare)

800 Prudential Dr
Jacksonville, FL 32207-8202
Phone (904) 202-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.8 of 100Reported as group
Quality
99.47
Improvement activities
40
Cost
83.62

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
789789989GAMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
US Anesthesia Partners of Florida Inc. Anesthesiologist Assistant CurrentSince Oct 10, 2023 Accepting new patients

Locations

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

800 Prudential Dr
Jacksonville, FL 32207
Phone (904) 202-2000

851 Trafalgar Ct
Ste 200E
Maitland, FL 32751
Phone (321) 422-7155

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1695254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1568240307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4616 TUTEN DR",
            "city": "BRISTOL",
            "state": "GA",
            "postal_code": "315183206",
            "telephone_number": "912-424-0538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "247 S MAIN ST",
            "city": "REIDSVILLE",
            "state": "GA",
            "postal_code": "304534605",
            "telephone_number": "912-557-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Prudential Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322078202",
            "country_code": "US",
            "telephone_number": "904-202-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "REGGIE",
        "credential": "CAA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-21",
        "last_updated": "2026-08-24",
        "certification_date": "2026-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "789789989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reidsville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.