NPIMap

Organization Active NPI

Daniel C. Bennett MD PA

  • Diagnostic Radiology Physician
  • Jacksonville, TX
National Provider Identifier
1699928069
Registry record updated Oct 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
K3092 Issued in TX
Legal business name
DANIEL C. BENNETT MD PA
Practice address
501 S Ragsdale St
Etmc Jacksonville Radiology Department
Jacksonville, TX 75766-2434
Phone
(903) 541-5171
NPI assigned
Oct 29, 2008
Last updated
Oct 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2008

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

Authorized official

Name
Daniel Christopher Bennett, MD
Title
Physician
Phone
(903) 541-5171

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X K3092 TX Primary

Addresses

Primary practice location

501 S Ragsdale St
Etmc Jacksonville Radiology Department
Jacksonville, TX 75766-2434

Mailing address

PO Box 1681
Jacksonville, TX 75766-1681
Phone (903) 541-5171

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1225238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225238400000",
    "number": "1699928069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1681",
            "city": "JACKSONVILLE",
            "state": "TX",
            "postal_code": "757661681",
            "telephone_number": "903-541-5171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S RAGSDALE ST",
            "address_2": "ETMC JACKSONVILLE RADIOLOGY DEPARTMENT",
            "city": "JACKSONVILLE",
            "state": "TX",
            "postal_code": "757662434",
            "telephone_number": "903-541-5171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL C. BENNETT MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-29",
        "last_updated": "2008-10-29",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "903-541-5171",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "K3092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; 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.