Individual provider Active NPI

William Mathew Bennetts, DC

  • Chiropractor
  • Pittsburg, KS
National Provider Identifier
1790850287
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
01-05618 Issued in KS
Practice address
206 1/2 S Broadway St
Pittsburg, KS 66762-5204
Phone
(620) 308-5151
Fax
(620) 308-1094
NPI assigned
Nov 21, 2006
Last updated
Jul 21, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 01-05618 KS Primary

Addresses

Primary practice location

206 1/2 S Broadway St
Pittsburg, KS 66762-5204

Mailing address

206 1/2 S Broadway St
Pittsburg, KS 66762-5204
Phone (620) 308-5151

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140424001529 KS Practitioner - Chiropractic 4789787086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

206 /2 S Broadway St
Pittsburg, KS 66762-5204
Phone (620) 798-7046

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Momentum Chiropractic LLC Chiropractor CurrentSince Dec 13, 2019 Accepting new patients
Chiro-Technology PC Chiropractor PastSince Nov 20, 2014 Accepting new patients

Locations

206 S Broadway St
Pittsburg, KS 66762
Phone (620) 308-5151

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1790850287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 1/2 S BROADWAY ST",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667625204",
            "telephone_number": "620-308-5151",
            "fax_number": "620-308-1094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 1/2 S BROADWAY ST",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667625204",
            "telephone_number": "620-308-5151",
            "fax_number": "620-308-1094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETTS",
        "first_name": "WILLIAM",
        "middle_name": "MATHEW",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KS",
            "license": "01-05618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburg, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.