Organization Active NPI

Brant Bennett, MD PLLC

  • Family Medicine Physician
  • Norman, OK
National Provider Identifier
1790343085
Registry record updated May 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BRANT BENNETT, MD PLLC
Practice address
3500 Healthplex Pkwy # 102
Norman, OK 73072-9738
Phone
(405) 307-6955
NPI assigned
May 31, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2019

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

Authorized official

Name
Dr. Brant Quinn Bennett, MDNPI 1841519360
Title
Physician
Phone
(405) 924-0050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

3500 Healthplex Pkwy # 102
Norman, OK 73072-9738

Mailing address

305 Summit Crest LN
Norman, OK 73071-4083
Phone (405) 924-0050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190723001436 OK Part B Supplier - Clinic/Group Practice 3375879745 Receives reassigned benefits from 1 practitioner
Practice locations: Norman, OK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1559260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559260800000",
    "number": "1790343085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 SUMMIT CREST LN",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730714083",
            "telephone_number": "405-924-0050",
            "fax_number": "405-293-4365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 HEALTHPLEX PKWY # 102",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730729738",
            "telephone_number": "405-307-6955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANT BENNETT, MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-31",
        "last_updated": "2019-05-31",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "BRANT",
        "authorized_official_middle_name": "QUINN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "405-924-0050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.