Dan Bennett, M.D., P.a.

Primary specialty

SpecialistTaxonomy code 174400000X

License

12818 Issued in MS

Legal business name

DAN BENNETT, M.D., P.A.

Practice address

2475 5TH St N
Columbus, MS 39705-2005

Phone

(662) 328-1254

Fax

(662) 327-2033

NPI assigned

May 13, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Marsha P Ward

Title

Clinic Manager

Phone

(662) 328-1254

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Bennett Ophthalmology Group Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Practitioners 1

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

• James Daniel Bennett III, M.D.

  • Ophthalmology Physician
  • Columbus, MS
  • NPI 1871596130
  Medicare reassignment NPD

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

{
    "created_epoch": "1179014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203292800000",
    "number": "1679788640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2475 5TH ST N",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397052005",
            "telephone_number": "662-328-1254",
            "fax_number": "662-327-2033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2475 5TH ST N",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397052005",
            "telephone_number": "662-328-1254",
            "fax_number": "662-327-2033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAN BENNETT, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-13",
        "last_updated": "2008-02-18",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "MARSHA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "662-328-1254",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MS",
            "license": "12818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08101054",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CM6726",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bennett Ophthalmology Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Audie Dauber
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• Janice Davidson, PHD FNP-BC FAANP
• Phyllis Davis-Webber

• Specialist in Columbus, MS
• Providers in Columbus, MS by specialty
• Specialist in Mississippi

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