Active NPI
Tanner Robin Bennett, AUD
- Audiologist
- Moses Lake, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- LD61301322
- Practice address
- 840 E Hill Ave
Moses Lake, WA 98837-2238 - Phone
- (509) 663-8711
- NPI assigned
- May 27, 2021
- Last updated
- May 10, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | LD61301322 | WA | Primary |
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 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://epicproxy.et0764.epichosted.com/FHIRProxy/api/FHIR/R4/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID, WA, NE
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Audiologist
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 477 | NE | MD | Mental Health Counselor |
| LD61301322 | WA | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Audio-Logic, PC | Audiologist | Current | Accepting new patients |
| Wenatchee Valley Hospital | Current | Accepting new patients | |
| Wenatchee Valley Hospital | Current | Accepting new patients | |
| Central Washington Health Services Association | 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
Organizations & group practices 6
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.
-
- Audiologist
- Columbus, NE
- NPI 1134314305
-
dba Confluence Health
- Emergency Medical Services (Emergency Medicine) Physician
- Wenatchee, WA
- NPI 1801937453
-
- Multi-Specialty Clinic/Center
- Wenatchee, WA
- NPI 1669719688
-
- Ophthalmology Physician
- Moscow, ID
- NPI 1407915325
-
- Clinical Medical Laboratory
- Wenatchee, WA
- NPI 1689916819
-
dba Access Family Care
- Federally Qualified Health Center (FQHC)
- Joplin, MO
- NPI 1538151733
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1652140800000",
"number": "1891361283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 N CHELAN AVE",
"city": "WENATCHEE",
"state": "WA",
"postal_code": "988012028",
"telephone_number": "509-663-8711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "840 E HILL AVE",
"city": "MOSES LAKE",
"state": "WA",
"postal_code": "988372238",
"telephone_number": "509-663-8711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "TANNER",
"middle_name": "ROBIN",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-27",
"last_updated": "2022-05-10",
"certification_date": "2022-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "WA",
"license": "LD61301322",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicproxy.et0764.epichosted.com/FHIRProxy/api/FHIR/R4/",
"affiliation": "N",
"address_1": "840 E Hill Ave",
"city": "Moses Lake",
"state": "WA",
"country_code": "US",
"postal_code": "988372238",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Moses Lake, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2022; 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.