Active NPI
James R. Bennett Jr., PA-C
- Physician Assistant
- Wilmington, NC
National Provider Identifier
1679742555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-01244
- Practice address
- 5220 Oleander Dr FL 2
Attn: Crendentialing
Wilmington, NC 28403-7021 - Phone
- (910) 395-8333
- Fax
- (910) 395-8473
- NPI assigned
- Feb 26, 2008
- Last updated
- Jan 26, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-01244 | NC | Primary |
Addresses
Primary practice location
5220 Oleander Dr FL 2
Attn: Crendentialing
Wilmington, NC 28403-7021
Mailing address
5220 Oleander Dr FL 2
Attn: Crendentialing
Wilmington, NC 28403-7021
Phone (910) 395-8333
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-01244 | NC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergeortho PA | Physician Assistant | Past | Accepting new patients |
Interoperability endpoints
- jamesbennett@bo.allscriptsdirect.net
Organizations & group practices 1
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": "1203984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485388800000",
"number": "1679742555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5220 OLEANDER DR FL 2",
"address_2": "ATTN: CRENDENTIALING",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284037021",
"telephone_number": "910-395-8333",
"fax_number": "910-395-8473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5220 OLEANDER DR FL 2",
"address_2": "ATTN: CRENDENTIALING",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284037021",
"telephone_number": "910-395-8333",
"fax_number": "910-395-8473"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "JAMES",
"middle_name": "R.",
"name_suffix": "Jr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-02-26",
"last_updated": "2017-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-01244",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.