Active NPI
Jessica Lynn Bennett, NNP-BC
- Neonatal Nurse Practitioner
- San Diego, CA
National Provider Identifier
1821483025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal Nurse Practitioner
- License
- NP95002665
- Practice address
- 3010 Childrens Way
San Diego, CA 92123-4223 - Phone
- (858) 966-5818
- NPI assigned
- Apr 3, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal Nurse Practitioner | 363LN0000X | NP95002665 | CA | Primary |
| Neonatal Intensive Care Registered Nurse | 163WN0002X | RN95065689 | CA |
Addresses
Primary practice location
3010 Childrens Way
San Diego, CA 92123-4223
Mailing address
3020 Childrens Way # Mc5008
San Diego, CA 92123-4223
Phone (858) 966-5818
Other practice location 1
2185 Citracado Pkwy
Escondido, CA 92029-4159
Phone (442) 282-3193
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 |
|---|---|---|---|
| RN95065689 | CA | MD | Neonatal Intensive Care Registered Nurse |
| NP95002665 | CA | MD | Neonatal Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Hospital Pediatric Associates, Inc | Past | Accepting new patients | |
| Rady Children'S Hospital San Diego | Past | Accepting new patients | |
| Marilyn Kaufhold, M.D., a Medical Corporation | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Children's Hospital
- San Diego, CA
- NPI 1336359389
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- San Diego, CA
- NPI 1851303994
-
- Pediatrics Physician
- Boston, MA
- NPI 1457306664
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634688000000",
"number": "1821483025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3020 CHILDRENS WAY # MC5008",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921234223",
"telephone_number": "858-966-5818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3010 CHILDRENS WAY",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921234223",
"telephone_number": "858-966-5818"
}
],
"practiceLocations": [
{
"address_1": "2185 Citracado Pkwy",
"address_purpose": "LOCATION",
"city": "Escondido",
"state": "CA",
"postal_code": "920294159",
"country_code": "US",
"telephone_number": "442-282-3193",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BENNETT",
"first_name": "JESSICA",
"middle_name": "LYNN",
"credential": "NNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-03",
"last_updated": "2021-10-20",
"certification_date": "2021-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "CA",
"license": "NP95002665",
"primary": true
},
{
"code": "163WN0002X",
"taxonomy_group": "",
"desc": "Registered Nurse, Neonatal Intensive Care",
"state": "CA",
"license": "RN95065689",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.