Michele L Bennett, MD – Family Medicine Physician

Key facts

NPI: 1851490874
Entity type: Individual (NPI type 1)
Primary specialty: Family Medicine Physician 207Q00000X
License: 6086A (WY)
Practice address: 248 W Works St
Sheridan, WY 82801-4213
Phone: (307) 673-6100
Fax: (307) 673-1975
NPI assigned: Sep 22, 2006
Sex: Female
Sole proprietor: No

Organizations & group practices 1

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.

Clay Pot Counseling, Inc. Clinical Social Worker · Crystal Lake, IL · NPI 1164456315

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Doctor of Medicine

State licenses

License	State	Type	Specialty
6086A	WY	MD	Family Medicine Physician

Practice roles

Organization	Specialty	Status	New patients
Clay Pot Counseling, Inc.		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Family Medicine Physician	207Q00000X	6086A	WY	Yes

Addresses

Primary practice location

248 W Works St
Sheridan, WY 82801-4213

Mailing address

248 W Works St
Sheridan, WY 82801-4213
Phone (307) 673-6100

Other identifiers

Identifier	Type	State	Issuer
113791300	Medicaid	WY
313726	Other	WY	BLUE CROSS/BLUE SHIELD

Other providers in Sheridan, WY

All providers in Sheridan, WY · Family Medicine Physician in Wyoming

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2012. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.