Richard Leroy Bennett Jr., MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101233413 Issued in VA

Practice address

1510 North 28TH Street
Suite 207
Richmond, VA 23223

Phone

(804) 649-0044

Fax

(804) 649-0758

NPI assigned

Dec 6, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Feb 8, 2016 through Feb 8, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Lillie R Bennett MD LTD

  • Pediatrics Physician
  • Richmond, VA
  • NPI 1255456414
  NPD (past)
• Lillie R Bennett MD LTD

  • Pediatrics Physician
  • Richmond, VA
  • NPI 1386762110
  NPD (past)

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699834796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 NORTH 28TH STREET",
            "address_2": "SUITE 207",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23223",
            "telephone_number": "804-649-0044",
            "fax_number": "804-649-0758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 NORTH 28TH STREET",
            "address_2": "SUITE 207",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23223",
            "telephone_number": "804-649-0044",
            "fax_number": "804-649-0758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "RICHARD",
        "middle_name": "LEROY",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101233413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6737188",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonathan David Bennett, M.D.
• Lillie Robinson Bennett, MD
• Lisa Bennett, MD
• Marvin Stephone Bennett
• Mary Keely Costello Bennett, AGACNP-BC
• Ines Benothmane, DPT
• Halimah Bakir Benson, LPN
• Kristen Frances Benson
• Larry L Benson, MD
• Laturra Benson, BCBA

• Pediatrics Physician in Richmond, VA
• Providers in Richmond, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.