Individual provider Active NPI

Brianna Elizabeth Cecelia Bennett, MS, LAT, ATC

  • Athletic Trainer
  • Jefferson, LA
National Provider Identifier
1649184060
Registry record updated Oct 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
354317 Issued in LA
Practice address
1201 S Clearview Pkwy BLDG B
Jefferson, LA 70121-1015
Phone
(504) 703-2620
NPI assigned
Oct 1, 2026
Last updated
Oct 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 354317 LA Primary

Addresses

Primary practice location

1201 S Clearview Pkwy BLDG B
Jefferson, LA 70121-1015

Mailing address

884 Carriage Hill Dr
Fenton, MI 48430-4137

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790812800000",
    "number": "1649184060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "884 CARRIAGE HILL DR",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484304137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S CLEARVIEW PKWY BLDG B",
            "city": "JEFFERSON",
            "state": "LA",
            "postal_code": "701211015",
            "telephone_number": "504-703-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "BRIANNA",
        "middle_name": "ELIZABETH CECELIA",
        "credential": "MS, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-10-01",
        "last_updated": "2026-10-01",
        "certification_date": "2026-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "LA",
            "license": "354317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.