Individual provider Active NPI

Matthew Bennett

  • Chiropractor
  • Elkhart, IN
National Provider Identifier
1578096996
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08002949A Issued in IN
Practice address
1178 Fremont CT
Elkhart, IN 46516-9321
Phone
(574) 293-7000
NPI assigned
Apr 4, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08002949A IN Primary

Addresses

Primary practice location

1178 Fremont CT
Elkhart, IN 46516-9321

Mailing address

1178 Fremont CT
Elkhart, IN 46516-9321

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170511000603 IN Practitioner - Chiropractic 5698052108 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2016
Medicare assignment
May accept Medicare assignment
Group practices
Schneider Clinic PCGroup PAC ID 9234179979, 2 clinicians

Practice addresses (Care Compare)

1178 Fremont CT
Suite 1
Elkhart, IN 46516-9321
Phone (574) 293-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bennett Chiropractic Wellness Center, LLC Chiropractor CurrentSince May 9, 2017 Accepting new patients

Locations

1178 Fremont Ct
Elkhart, IN 46516
Phone (574) 238-6199

1178 Fremont Ct
#1
Elkhart, IN 46516
Phone (574) 293-7000

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.

NPI Registry JSON

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1578096996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1178 FREMONT CT",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465169321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1178 FREMONT CT",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465169321",
            "telephone_number": "574-293-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "MATTHEW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-04",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002949A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; 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.