Jerry D Bennett, MD
Individual provider Active NPI Emergency Medicine Physician · Sherman, TX
NPI 1699768119 · NPPES record last updated Mar 31, 2021
Key facts
- NPI
- 1699768119
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- F9192 (TX)
- Practice address
- 706 Legend LN
Sherman, TX 75092-5421 - Phone
- (903) 891-2139
- NPI assigned
- Aug 30, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- University of Texas Medical Branch at Galveston, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Level One Emergency Physicians LLC
Practice addresses (Care Compare)
5016 S US Hwy 75
Denison, TX 75020-4584
Phone (903) 416-4000
Hospital & facility affiliations
- Texoma Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040715000904 | TX | Practitioner - Family Practice |
9739168543 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sherman Grayson Hospital LLC | Current | Accepting new patients | |
| Nes Southwest Medical Services Inc | Emergency Medicine | Current |
Accepting new patients |
| Level One Emergency Specialists LLC | Emergency Medicine | Current |
Accepting new patients |
| Level One Emergency Physicians LLC | Emergency Medicine | Current |
Accepting new patients |
| Uhs of Texoma, Inc | Past | Accepting new patients |
Locations
2710 W Hackberry Ln
Anna, TX 75409
Phone (214) 831-2600
5016 US Highway 75
Denison, TX 75020
Phone (855) 222-9637
4226 N US Highway 75
Sherman, TX 75090
Phone (903) 487-0857
500 N Highland Ave
Sherman, TX 75092
Phone (903) 870-4494
Interoperability endpoints
- jerry.bennett@3202.securemail.prognocis.com
- jerrybennett@wnjrmc.allscriptsdirect.net
- jerry.bennett@3201.securemail.prognocis.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | F9192 | TX | |
| Emergency Medicine Physician | 207P00000X | F9192 | TX | Yes |
Addresses
Primary practice location
706 Legend LN
Sherman, TX 75092-5421
Mailing address
706 Legend LN
Sherman, TX 75092-5421
Phone (903) 814-0303
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 140179633 | Medicaid | TX | |
| 140179634 | Medicaid | TX | |
| 85Z525 | Other | TX | BCBS |
Other providers in Sherman, TX
- Behavioral Concepts, Inc.
- Bella Fontana Spa, LTD.
- Amanda Bennett
- B'Randa Jacqueline Bennett
- Jana Lynne Bennett
- Maci Bennett
- Rachel Bennett
- Richard Bennett
- Amy Bentley
- Chani Bergen
All providers in Sherman, TX · Emergency Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 31, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.