NPIMap

Individual provider Active NPI

Fletcher K Bennett-Gayle, P.A.-C

  • Physician Assistant
  • Midlothian, VA
National Provider Identifier
1750307690
Registry record updated Dec 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110001514 Issued in VA
Practice address
3742 Winterfield Rd
Midlothian, VA 23113-9238
Phone
(804) 330-3335
Fax
(804) 330-9205
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 7

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.

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)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MP634NJMDPhysician Assistant
005805NYMDPhysician Assistant
0110001514VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Healthcare of Central Virginia Inc PastSince Apr 1, 2019 Accepting new patients
Virginia Emergency Group LLC Emergency Medicine Past Accepting new patients
Virginia Emergency Physicians LLP Emergency Medicine Past Accepting new patients
Virginia Emergency Physicians LLP Emergency Medicine Past Accepting new patients
Recorian Wellness Services, LLC PastSince Dec 6, 2020 Accepting new patients
Virginia Emergency Physicians LLP Emergency Medicine Past Accepting new patients
Virginia Emergency Physicians LLP Emergency Medicine Past Accepting new patients

Specialties & licenses 4

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 005805 NY
Physician Assistant 363A00000X MP634 NJ
Physician Assistant 363A00000X 0110001514 VA Primary
Emergency Medicine Physician 207P00000X 0110001514 VA

Addresses

NPPES NPI Registry

Primary practice location

3742 Winterfield Rd
Midlothian, VA 23113-9238

Mailing address

3742 Winterfield Rd
Midlothian, VA 23113-9238
Phone (804) 330-3335

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 13, 2010.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292198400000",
    "number": "1750307690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3742 WINTERFIELD RD",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231139238",
            "telephone_number": "804-330-3335",
            "fax_number": "804-330-9205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3742 WINTERFIELD RD",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231139238",
            "telephone_number": "804-330-3335",
            "fax_number": "804-330-9205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT-GAYLE",
        "first_name": "FLETCHER",
        "middle_name": "K",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2010-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "005805",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "MP634",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110001514",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0110001514",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; 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.