Individual provider Active NPI

Stephanie Bennett, RN

  • Registered Nurse
  • Monroe, GA
National Provider Identifier
1710227939
Registry record updated Apr 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN077666 Issued in GA
Practice address
226 Alcovy St
Monroe, GA 30655-2183
Phone
(770) 267-8461
NPI assigned
Feb 25, 2013
Last updated
Apr 11, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN077666 GA Primary

Addresses

Primary practice location

226 Alcovy St
Monroe, GA 30655-2183

Mailing address

226 Alcovy St
Monroe, GA 30655-2183

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20130313000146 GA Practitioner - Nurse Practitioner 6507011863 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN077666GAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Apogee Medical Group Georgia Inc CurrentSince Feb 18, 2013 Accepting new patients
Hospital Physician Services - Southeast Professional Corporation CurrentSince Jan 1, 2015 Accepting new patients

Locations

501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291

801 W Gordon St
Thomaston, GA 30286
Phone (706) 647-4371

915 Gordon Ave
Thomasville, GA 31792
Phone (229) 228-8575

2501 N Patterson St
Valdosta, GA 31602
Phone (229) 259-4139

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1361750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523404800000",
    "number": "1710227939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 ALCOVY ST",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306552183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 ALCOVY ST",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306552183",
            "telephone_number": "770-267-8461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "STEPHANIE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-25",
        "last_updated": "2018-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN077666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, GA

Sources for this page

Verify at the official NPI Registry.