Active NPI
Robert E Bennett Jr.
- Pharmacist
- Baxley, GA
National Provider Identifier
1891492674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RHP013312
- Practice address
- 19 E Parker St
Baxley, GA 31513-0056 - Phone
- (912) 367-7024
- NPI assigned
- Feb 13, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | RHP013312 | GA | Primary |
Addresses
Primary practice location
19 E Parker St
Baxley, GA 31513-0056
Mailing address
295 Flint Creek Dr
Richmond Hill, GA 31324-3716
Phone (912) 663-4366
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RHP013312 | GA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676246400000",
"number": "1891492674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "295 FLINT CREEK DR",
"city": "RICHMOND HILL",
"state": "GA",
"postal_code": "313243716",
"telephone_number": "912-663-4366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 E PARKER ST",
"city": "BAXLEY",
"state": "GA",
"postal_code": "315130056",
"telephone_number": "912-367-7024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNETT",
"first_name": "ROBERT",
"middle_name": "E",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-02-13",
"last_updated": "2023-02-13",
"certification_date": "2023-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RHP013312",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baxley, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.