Shane Bennett, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

ARNP9323265 Issued in FL

Practice address

2106 S Lois Ave
Tampa, FL 33629-5659

Phone

(813) 844-4200

NPI assigned

Nov 21, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Wound Technology Network Inc

  • Infectious Disease Physician
  • Orlando, FL
  • NPI 1962601393
  Medicare reassignment NPD
• WT Health of Florida LLC

  • Infectious Disease Physician
  • Orlando, FL
  • NPI 1982434106
  Medicare reassignment NPD
• Minuteclinic LLC

  • Family Nurse Practitioner
  • Rockville, MD
  • NPI 1134191836

  FL

  Medicare reassignment NPD

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

{
    "created_epoch": "1511222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515628800000",
    "number": "1780198168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2106 S LOIS AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336295659",
            "telephone_number": "813-844-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 S LOIS AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336295659",
            "telephone_number": "813-844-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "SHANE",
        "name_prefix": "Mr.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-21",
        "last_updated": "2018-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9323265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer L Bennett, MD
• Kasalou Bennett, BS
• Rachel Minchey Bennett
• Richard Bennett, DO
• Robert David Bennett, MD
• Tonnie Fitzroy Bennett Jr.
• Zekecia Jamia Bennett, MSW, LCSW
• Alan Bennie, M.D.
• Lauryn Ann Benninger
• Michael Spencer Benrubi, DO

• Nurse Practitioner in Tampa, FL
• Providers in Tampa, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.