Active NPI
Patricia Anne Bennett
- Pharmacy Technician
- Boone, IA
National Provider Identifier
1760069579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 5243
- Practice address
- 1515 SE Marshall St
Boone, IA 50036-7149 - Phone
- (515) 432-3484
- NPI assigned
- Mar 26, 2021
- Last updated
- Mar 26, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | 5243 | IA | Primary |
Addresses
Primary practice location
1515 SE Marshall St
Boone, IA 50036-7149
Mailing address
1515 SE Marshall St
Boone, IA 50036-7149
Phone (515) 432-3484
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5243 | IA | MD | Pharmacy Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past | Accepting new patients | |
| Walmart Inc. | Past | Accepting new patients |
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": "1616716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616716800000",
"number": "1760069579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1515 SE MARSHALL ST",
"city": "BOONE",
"state": "IA",
"postal_code": "500367149",
"telephone_number": "515-432-3484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1515 SE MARSHALL ST",
"city": "BOONE",
"state": "IA",
"postal_code": "500367149",
"telephone_number": "515-432-3484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "PATRICIA",
"middle_name": "ANNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-26",
"last_updated": "2021-03-26",
"certification_date": "2021-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "IA",
"license": "5243",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boone, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.