Active NPI
Laura A. Bennett, PT
- Physical Therapist
- Concord, NC
National Provider Identifier
1881705739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- P13554
- Practice address
- 354 Copperfield Blvd NE
Concord, NC 28025-2402 - Phone
- (704) 262-4181
- Fax
- (704) 721-0916
- NPI assigned
- Aug 31, 2006
- Last updated
- Nov 26, 2014
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT00007802 | WA | |
| Physical Therapist | 225100000X | P13554 | NC | Primary |
Addresses
Primary practice location
354 Copperfield Blvd NE
Concord, NC 28025-2402
Mailing address
4601 Park Rd
Suite 300
Charlotte, NC 28209-3239
Phone (704) 323-2424
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 49375U | Other | WA | REGENCE BLUE SHIELD PIN |
Other names 1
- Laura A. Lennon
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT00007802 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416960000000",
"number": "1881705739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4601 PARK RD",
"address_2": "SUITE 300",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282093239",
"telephone_number": "704-323-2424",
"fax_number": "704-945-7681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "354 COPPERFIELD BLVD NE",
"city": "CONCORD",
"state": "NC",
"postal_code": "280252402",
"telephone_number": "704-262-4181",
"fax_number": "704-721-0916"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "LAURA",
"middle_name": "A.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2014-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT00007802",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P13554",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD PIN",
"identifier": "49375U",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LAURA",
"last_name": "LENNON",
"middle_name": "A.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Concord, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.