Tanner Robin Bennett, AUD
Individual provider Active NPI Audiologist · Moses Lake, WA
NPI 1891361283 · NPPES record last updated May 10, 2022
Key facts
- NPI
- 1891361283
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Audiologist 231H00000X
- License
- LD61301322 (WA)
- Practice address
- 840 E Hill Ave
Moses Lake, WA 98837-2238 - Phone
- (509) 663-8711
- NPI assigned
- May 27, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Qualified Audiologist
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Clearview Eye Clinic LTD
Audio-Logic, PC
Practice addresses (Care Compare)
2500 W a St
Suite 202
Moscow, ID 83843-6000
Phone (208) 882-4662
3763 39TH Ave
Suite 300
Columbus, NE 68601-4530
Phone (402) 564-9198
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in ID, WA, NE
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210615003374 | ID | Practitioner - Qualified Audiologist | 0143620997 | |
| I20220519001282 | WA | Practitioner - Qualified Audiologist | 0143620997 | Reassigns benefits to 2 organizations |
| I20250429001923 | NE | Practitioner - Qualified Audiologist | 0143620997 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Audio-Logic, PC | Audiologist-Hearing Aid Fitter | Current |
Accepting new patients |
| Central Washington Health Services Association | Current | Accepting new patients | |
| Wenatchee Valley Hospital | Current |
Accepting new patients | |
| Wenatchee Valley Hospital | Current | Accepting new patients | |
| Ozark Tri-County Health Care Consortium | Past | Accepting new patients |
Locations
3763 39th Ave
Ste 300
Columbus, NE 68601
Phone (402) 564-9198
840 E Hill Ave
Moses Lake, WA 98837
Phone (509) 764-6400
17 S Western Ave
Tonasket, WA 98855
Phone (509) 486-2174
1201 S Miller St
Wenatchee, WA 98801
Phone (509) 662-2208
820 N Chelan Ave
Wenatchee, WA 98801
Phone (509) 863-4868
933 Red Apple Rd
Wenatchee, WA 98801
Phone (509) 655-6125
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | LD61301322 | WA | Yes |
Addresses
Primary practice location
840 E Hill Ave
Moses Lake, WA 98837-2238
Mailing address
820 N Chelan Ave
Wenatchee, WA 98801-2028
Phone (509) 663-8711
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0764.epichosted.com/FHIRProxy/api/FHIR/R4/ |
Other providers in Moses Lake, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.