Mary P Bennerman, R.D., LDN, CDE

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

L000337 Issued in NC

Practice address

7300 S Raeford Rd
Fayetteville, NC 28304-6162

Phone

(910) 475-6296

NPI assigned

Apr 17, 2008

Last updated

Sep 18, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1669646048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 RAEFORD RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283040807",
            "telephone_number": "910-488-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 S RAEFORD RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283046162",
            "telephone_number": "910-475-6296"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "683 E Palmer St",
            "address_purpose": "LOCATION",
            "city": "Raeford",
            "state": "NC",
            "postal_code": "283766648",
            "country_code": "US",
            "telephone_number": "910-875-3717",
            "fax_number": "910-875-6351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNERMAN",
        "first_name": "MARY",
        "middle_name": "P",
        "name_prefix": "Mrs.",
        "credential": "R.D., LDN, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-17",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NC",
            "license": "L000337",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NC",
            "license": "L000337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benevolent Care LLC
• Benevolent Counseling, PLLC (Benevolent Counseling)
• Lakeish Benjamin
• Latonya Benjamin, CADC-I
• Shamyia Benn
• Asia Bennett
• Carl Bennett, LCSWA
• David Bennett Jr.
• Ericka Bennett
• Gloria Renee Bennett

• Registered Dietitian in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Registered Dietitian in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; 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.