Holly D. Bennett, R.N.APN,C.

Key facts

NPI

1861784423

Entity type

Individual (NPI type 1)

Primary specialty

Adult Health Nurse Practitioner 363LA2200X

License

26NJ00322500 (NJ)

Practice address

310 Chris Gaupp Dr
Suite 102
Galloway, NJ 08205-4461

Phone

(609) 652-9933

Fax

(609) 652-9955

NPI assigned

May 13, 2011

Sex

Female

Sole proprietor

No

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.

• Atlanticare Physician Group PA Clinic/Center · Egg Harbor Township, NJ · NPI 1093829608
  Medicare reassignment Care Compare group NPD NJ
• Atlanticare Physician Group, PA Urgent Care Clinic/Center · Galloway, NJ · NPI 1003820622
  NPD
• Atlanticare Physician Group Primary Care Clinic/Center · Ventnor City, NJ · NPI 1194839910
  NPD (past)

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Atlanticare Regional Medical Center General Acute Care Hospital · Pomona, NJ · NPI 1013919315
  Care Compare affiliation Hospital
• Bayada Home Health Care, Inc. Home Health Agency · Egg Harbor Township, NJ · NPI 1922820901
  Care Compare affiliation Home health agency
• LHCG CXLV, LLC Home Health Agency · Egg Harbor Township, NJ · NPI 1154884401
  Care Compare affiliation Home health agency

Medicare Care Compare profile

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Atlanticare Physician Group PA (506 clinicians)

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bayada Home Health Care, Inc. Home health agency · Egg Harbor Township, NJ · CCN 317066
• Patient Care Home health agency · Egg Harbor Township, NJ · CCN 317072
• Atlanticare Regional Medical Center - City Campus Hospital · Atlantic City, NJ · CCN 310064

Medicare participation

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 13, 2011.

{
    "created_epoch": "1305244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305244800000",
    "number": "1861784423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 CHRIS GAUPP DR",
            "address_2": "SUITE 102",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082054461",
            "telephone_number": "609-652-9933",
            "fax_number": "609-652-9955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 CHRIS GAUPP DR",
            "address_2": "SUITE 102",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082054461",
            "telephone_number": "609-652-9933",
            "fax_number": "609-652-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "HOLLY",
        "middle_name": "D.",
        "name_prefix": "Miss",
        "credential": "R.N.APN,C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-13",
        "last_updated": "2011-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00322500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE P10",
            "identifier": "195242",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Galloway, NJ · Adult Health Nurse Practitioner in New Jersey