Active NPI
Martha Bennett, M.D.
- Family Medicine Physician
- Edmonds, WA
National Provider Identifier
1619073293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 00017685
- Practice address
- 7315 212TH St SW
Suite 101
Edmonds, WA 98026-7610 - Phone
- (425) 775-9474
- Fax
- (425) 670-3554
- NPI assigned
- Sep 15, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 00017685 | WA | Primary |
Addresses
Primary practice location
7315 212TH St SW
Suite 101
Edmonds, WA 98026-7610
Mailing address
7315 212TH St SW
Suite 101
Edmonds, WA 98026-7610
Phone (425) 775-9474
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1007574 | Medicaid | WA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00017685 | WA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391558400000",
"number": "1619073293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7315 212TH ST SW",
"address_2": "SUITE 101",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980267610",
"telephone_number": "425-775-9474",
"fax_number": "425-670-3554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7315 212TH ST SW",
"address_2": "SUITE 101",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980267610",
"telephone_number": "425-775-9474",
"fax_number": "425-670-3554"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "MARTHA",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-15",
"last_updated": "2014-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "00017685",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1007574",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Edmonds, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.