Individual provider Active NPI

Kari Ann Bennett, D.C.

  • Chiropractor
  • Gillette, WY
National Provider Identifier
1649440157
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
783 Issued in WY
Practice address
201 W Lakeway Rd Ste 211
Gillette, WY 82718-6341
Phone
(307) 682-7885
Fax
(307) 682-2153
NPI assigned
Mar 11, 2008
Last updated
Mar 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1585 NE
Chiropractor 111N00000X 783 WY Primary
Chiropractor 111N00000X 1226 SD

Addresses

Primary practice location

201 W Lakeway Rd Ste 211
Gillette, WY 82718-6341

Mailing address

201 W Lakeway Rd Ste 211
Gillette, WY 82718-6341
Phone (307) 682-7885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, WY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130930000151 SD Practitioner - Chiropractic 9739225509 Reassigns benefits to 1 organization
I20190702001924 WY Practitioner - Chiropractic 9739225509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

201 W Lakeway Rd
Suite 211
Gillette, WY 82718-6341
Phone (307) 682-7885

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1226SDMDChiropractor
783WYMDDental Hygienist
1585NEMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aoc Medical LLC Current Accepting new patients
Active Living Chiropractic P.C. Chiropractor CurrentSince Jul 13, 2013 Accepting new patients
Active Life Family Chiropractic, P.C. Chiropractor PastSince Aug 1, 2005 Accepting new patients

Locations

138 E Hudson St
Spearfish, SD 57783
Phone (563) 639-9454

201 W Lakeway Rd
Ste 200
Gillette, WY 82718
Phone (307) 387-9850

201 W Lakeway Rd
Ste 211
Gillette, WY 82718
Phone (307) 217-2323

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1649440157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W LAKEWAY RD STE 211",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827186341",
            "telephone_number": "307-682-7885",
            "fax_number": "307-682-2153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W LAKEWAY RD STE 211",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827186341",
            "telephone_number": "307-682-7885",
            "fax_number": "307-682-2153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "KARI",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-11",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1585",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WY",
            "license": "783",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SD",
            "license": "1226",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gillette, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; 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.