Shaughn C Bennett DO PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS5245 Issued in FL

Legal business name

SHAUGHN C BENNETT DO PA

Practice address

7575 SW 62ND Ave
Suite B
South Miami, FL 33143-4955

Phone

(305) 661-0181

NPI assigned

Apr 10, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Shaughn C Bennett, D.O.NPI 1891758132

Title

Owner/Physician

Phone

(305) 926-5844

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shaughn C Bennett, D.O.

  • Family Medicine Physician
  • Miami, FL
  • NPI 1891758132
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1639342645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7575 SW 62ND AVE",
            "address_2": "SUITE B",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434955",
            "telephone_number": "305-661-0181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7575 SW 62ND AVE",
            "address_2": "SUITE B",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434955",
            "telephone_number": "305-661-0181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAUGHN C BENNETT DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-10",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "SHAUGHN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "305-926-5844",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS5245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1891758132",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Stephanie Shaw
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• Mei-Yin Shen
• Tyler Shepard, CRNA
• Sheridan Healthcorp Inc

• Family Medicine Physician in South Miami, FL
• Providers in South Miami, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.