Individual provider Active NPI

J. Michael Bennett, PHARM D

  • Pharmacist
  • Mobile, AL
National Provider Identifier
1598886335
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
14492 Issued in AL
Practice address
3207 International Dr
Suite F
Mobile, AL 36606-3020
Phone
(251) 478-0758
Fax
(251) 478-0227
NPI assigned
Apr 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 20379 GA
Pharmacist 183500000X 14492 AL Primary
Pharmacist 183500000X 22976 TN
Pharmacist 183500000X PD10051 AR
Pharmacist 183500000X 013248 KY
Pharmacist 183500000X 017989 LA

Addresses

Primary practice location

3207 International Dr
Suite F
Mobile, AL 36606-3020

Mailing address

8279 Magnolia Village Dr N
Mobile, AL 36695-6237
Phone (251) 478-0758

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PD10051ARMDPharmacist
20379GAMDPharmacist
013248KYMDPharmacist
017989LAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Burklow Development Inc Past Accepting new patients
Applied Pharmacy Services, Inc Past Accepting new patients

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": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598886335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8279 MAGNOLIA VILLAGE DR N",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366956237",
            "telephone_number": "251-478-0758",
            "fax_number": "251-478-0758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3207 INTERNATIONAL DR",
            "address_2": "SUITE F",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366063020",
            "telephone_number": "251-478-0758",
            "fax_number": "251-478-0227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "J.",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PHARM D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "20379",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "14492",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "22976",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AR",
            "license": "PD10051",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "KY",
            "license": "013248",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "017989",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.