Individual provider Active NPI

Vivian Bennett, NP

  • Family Nurse Practitioner
  • Danvers, MA
National Provider Identifier
1700960796
Registry record updated Jul 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
212621 Issued in MA
Practice address
480 Maple St
Danvers, MA 01923-4065
Phone
(978) 304-8600
Fax
(978) 304-8621
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 212621 MA Primary

Addresses

Primary practice location

480 Maple St
Danvers, MA 01923-4065

Mailing address

24 Central St
Marblehead, MA 01945-3002
Phone (781) 631-1111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110307000617 MA Practitioner - Nurse Practitioner 3173705597 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lynn Community Health, Inc.Group PAC ID 0042217507, 95 clinicians

Practice addresses (Care Compare)

269 Union St
Lynn, MA 01901-1314
Phone (959) 216-7305

Hospital & facility affiliations

  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
212621MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care Operations, PC CurrentSince Feb 4, 2018 Accepting new patients
Urgent Care Operations PC Current Accepting new patients
Bayon Medical Group LLC CurrentSince Apr 16, 2023 Accepting new patients
Urgent Care Operations PC CurrentSince Feb 4, 2018 Accepting new patients

Locations

50 Dodge St
Ste 104
Beverly, MA 01915
Phone (978) 922-2171

1075 Westford St
Ste 204
Lowell, MA 01851
Phone (978) 452-2000

280 Union St
Ste 402
Lynn, MA 01901
Phone (781) 780-7755

450 Paradise Rd
Swampscott, MA 01907
Phone (781) 581-1327

Interoperability endpoints

  • Direct secure messaging: vbennett306351@direct.ochin.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438214400000",
    "number": "1700960796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 CENTRAL ST",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019453002",
            "telephone_number": "781-631-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 MAPLE ST",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019234065",
            "telephone_number": "978-304-8600",
            "fax_number": "978-304-8621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "VIVIAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2015-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "212621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

Verify at the official NPI Registry.