Active NPI
Kathy R Bennett, D.C.
- Chiropractor
- Caldwell, ID
National Provider Identifier
1720107170
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(14) exclusion effective May 19, 2016.
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CHIA532
- Practice address
- 923 Grant St
Caldwell, ID 83605-4137 - Phone
- (208) 454-9000
- Fax
- (208) 454-9092
- NPI assigned
- Mar 28, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHIA532 | ID | Primary |
Addresses
Primary practice location
923 Grant St
Caldwell, ID 83605-4137
Mailing address
923 Grant St
Caldwell, ID 83605-4137
Phone (208) 454-9000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHIA532 | ID | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720107170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "923 GRANT ST",
"city": "CALDWELL",
"state": "ID",
"postal_code": "836054137",
"telephone_number": "208-454-9000",
"fax_number": "208-454-9092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "923 GRANT ST",
"city": "CALDWELL",
"state": "ID",
"postal_code": "836054137",
"telephone_number": "208-454-9000",
"fax_number": "208-454-9092"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "KATHY",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "ID",
"license": "CHIA532",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Caldwell, ID
Sources for this page
- 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; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.