Rachel Bennefield
Individual provider Active NPI Family Nurse Practitioner · Valdosta, GA
NPI 1760028856 · NPPES record last updated Nov 23, 2019
Key facts
- NPI
- 1760028856
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- RN228177 (GA)
- Practice address
- 2412 N Oak St
Valdosta, GA 31602-2567 - Phone
- (229) 244-5512
- Fax
- (229) 244-5512
- NPI assigned
- Nov 23, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Privia Medical Group of Georgia LLC
Practice addresses (Care Compare)
101 Yorktown Dr
Fayetteville, GA 30214-1578
951 S Broad St
Thomasville, GA 31792-6161
Phone (229) 228-4130
Hospital & facility affiliations
- Archbold Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200227002646 | GA | Practitioner - Nurse Practitioner | 2466889647 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN228177 | GA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Privia Medical Group of Georgia LLC | Multi-Specialty | Current |
Accepting new patients |
| Privia Medical Group of Georgia LLC | Multi-Specialty | Current |
Accepting new patients |
| Hospital Authority of the City of Bainbridge and Decatur County | Multi-Specialty | Past | Accepting new patients |
Locations
101 Yorktown Dr
Ste 100
Fayetteville, GA 30214
Phone (770) 460-4285
951 S Broad St
Thomasville, GA 31792
Phone (229) 228-4130
Interoperability endpoints
- https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
- rachel.bennefield.1@8042.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner |
363LF0000X | RN228177 | GA | Yes |
Addresses
Primary practice location
2412 N Oak St
Valdosta, GA 31602-2567
Mailing address
2412 N Oak St
Valdosta, GA 31602-2567
Phone (229) 244-5512
Other providers in Valdosta, GA
- Lynn Rae Bell
- Sharleece Bellagosi
- Bemiss Dental Care PC
- Deann Benefield
- Benevolent Hearts, LLC
- Bennett & Maxwell Family Dentistry
- Bennett P Hogan MD PC
- Jerry Dell Bennett Jr.
- Paula L Bennett
- Robert Daniel Bennett
All providers in Valdosta, GA · Family Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 23, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.