Brent Bennett MD PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G3150 Issued in TX

Legal business name

BRENT BENNETT MD PA

Practice address

2300 Lohmans Spur
#106
Lakeway, TX 78734-6206

Phone

(512) 263-7133

Fax

(512) 263-0451

NPI assigned

Mar 10, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Brent L. Bennett, M.D.NPI 1871561035

Title

Owner/President

Phone

(512) 263-7133

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Brent Bennett MD Other name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

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

• Brent L. Bennett, M.D.

  • Internal Medicine Physician
  • Lakeway, TX
  • NPI 1871561035
  Medicare reassignment NPD Authorized official
• Carol Elaine Baker, NP-C

  • Family Nurse Practitioner
  • Lakeway, TX
  • NPI 1144267808
  Medicare reassignment NPD

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396915200000",
    "number": "1790753192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 LOHMANS SPUR",
            "address_2": "#106",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787346206",
            "telephone_number": "512-263-7133",
            "fax_number": "512-263-0451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 LOHMANS SPUR",
            "address_2": "#106",
            "city": "LAKEWAY",
            "state": "TX",
            "postal_code": "787346206",
            "telephone_number": "512-263-7133",
            "fax_number": "512-263-0451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENT BENNETT MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-10",
        "last_updated": "2014-04-08",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "512-263-7133",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "G3150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP #",
            "identifier": "DN3479",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS GROUP #",
            "identifier": "0049KZ",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167436801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brent Bennett MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Internal Medicine Physician in Lakeway, TX
• Providers in Lakeway, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2014; 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.