Elizabeth Emily Bennett, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP95010098 Issued in CA

Practice address

975 S Fairmont Ave
Lodi, CA 95240-5118

Phone

(209) 333-3135

NPI assigned

Oct 24, 2018

Last updated

Jun 20, 2019By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1540339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560988800000",
    "number": "1699242065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N FAIRMONT AVE",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952401614",
            "telephone_number": "209-712-6531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 S FAIRMONT AVE",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952405118",
            "telephone_number": "209-333-3135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8110 Timberlake Way",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958235401",
            "country_code": "US",
            "telephone_number": "916-689-4111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "ELIZABETH",
        "middle_name": "EMILY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-24",
        "last_updated": "2019-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95010098",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "812638",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA BOARD OF REGISTERED NURSING",
            "identifier": "NP95010098",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Belousov, OTR/L
• Megan Belzer, RD
• Elizabeth Bender, NURSE PRACTITIONER
• Bennett Medical Services Inc
• Donna Marlane Bennett, FNP
• Malcolm Andrew Berean, LMFT
• Franklin Otto Bernhoft, PH.D.
• Michelle Ellen Besse, LMFT
• Beyond Barriers, Inc.
• Dhawal Bhanushali, PT

• Family Nurse Practitioner in Lodi, CA
• Providers in Lodi, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2019; 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.