Mark Richard Bennett Jr.

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

D131948 Issued in IA

Practice address

709 W Main St
Manchester, IA 52057-1526

Phone

(563) 822-1435

Fax

(563) 822-1436

NPI assigned

Mar 23, 2016

Last updated

Feb 19, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA, WA, OR3 enrollments

Enrollment records 3

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

University of Iowa, RJ & L Carver College of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesia Associates Northwest LLCGroup PAC ID 7618908484, 80 clinicians

Sweet Dreams AnesthesiaGroup PAC ID 1052770633, 3 clinicians

Emerald Valley AnesthesiaGroup PAC ID 8729437199, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/5c5c3b5c-6128-40bc-b71b-102ccb82d7e7/

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.

• Anesthesia Associates Northwest LLC

  • Anesthesiology Physician
  • Milwaukie, OR
  • NPI 1548281751
  Medicare reassignment Care Compare group NPD
• Emerald Valley Anesthesia

  • Certified Registered Nurse Anesthetist
  • Springfield, OR
  • NPI 1679355820

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• Sweet Dreams Anesthesia

  • Anesthesiology Physician
  • North Bend, OR
  • NPI 1518654425
  Medicare reassignment Care Compare group
• Anesthesia Iowa PLC

  • Anesthesiology Physician
  • Pella, IA
  • NPI 1114018983
  Medicare reassignment NPD
• Waverly Health Center

  dba Waverly Health Center Anesthesia

  • Certified Registered Nurse Anesthetist
  • Waverly, IA
  • NPI 1033125463

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Chelan County Public Hospital District No 2

  dba Lake Chelan Community Hospital

  • Critical Access Hospital
  • Chelan, WA
  • NPI 1578568853
  Medicare reassignment NPD
• Coquille Valley Hospital District

  • Critical Access Hospital
  • Coquille, OR
  • NPI 1730223967
  Medicare reassignment NPD
• Grant County Public Hospital District 1

  dba Samaritan Clinic

  • Rural Health Clinic/Center
  • Moses Lake, WA
  • NPI 1619086766
  Medicare reassignment NPD
• Hospitalist Medicine Physicians of Washington - TCS

  • Anesthesiology Physician
  • Portland, OR
  • NPI 1649816380

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Okanogan County Public Hospital District No. 3

  dba Mid-Valley Hospital

  • Critical Access Hospital
  • Omak, WA
  • NPI 1255387403
  Medicare reassignment NPD
• Okanogan Douglas County Hospital Dist 1

  dba Three Rivers Hospital

  • Critical Access Hospital
  • Brewster, WA
  • NPI 1205942257
  Medicare reassignment NPD
• Springfield Or Anesthesia Associates LLC

  dba Springfield Or Anesthesia

  • Certified Registered Nurse Anesthetist
  • Springfield, OR
  • NPI 1487158390

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550534400000",
    "number": "1871955435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 W MAIN ST",
            "city": "MANCHESTER",
            "state": "IA",
            "postal_code": "520571526",
            "telephone_number": "563-822-1435",
            "fax_number": "563-822-1436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 W MAIN ST",
            "city": "MANCHESTER",
            "state": "IA",
            "postal_code": "520571526",
            "telephone_number": "563-822-1435",
            "fax_number": "563-822-1436"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Hawkins Dr",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522421009",
            "country_code": "US",
            "telephone_number": "319-356-2633",
            "fax_number": "319-356-2940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "MARK",
        "middle_name": "RICHARD",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-23",
        "last_updated": "2019-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IA",
            "license": "D131948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Applewhite Dental Iowa PC (Manchester Dental)
• Audrey Armbrecht
• Bridget Milene Baker, DNP, ARNP, FNP-BC, P
• Barry Wound & Wellness PLLC
• Ashley Anne Barry, FNP-BC
• Allison Rae Berns, PA-C
• Beyond Speech Therapy LLC
• Brady N Blazek, CRNA, DNP
• Emily J Boge I, RDH BS MPA
• Ralph Ried Boom, M.D.

• Certified Registered Nurse Anesthetist in Manchester, IA
• Providers in Manchester, IA by specialty
• Certified Registered Nurse Anesthetist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; 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.