Audrey Phillips Bennett, CRNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

A0310068 Issued in AL

Practice address

10175 Little Patuxent Pkwy
Columbia, MD 21044-2655

Phone

(251) 604-4785

NPI assigned

Apr 8, 2010

Last updated

Aug 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

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.

• Patients 1St of Dothan, LLC

  • Family Medicine Physician
  • Dothan, AL
  • NPI 1336445014
  NPD (past)

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

{
    "created_epoch": "1270684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1902122591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 LIGHTHOUSE DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363057302",
            "telephone_number": "334-798-1555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10175 LITTLE PATUXENT PKWY",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442655",
            "telephone_number": "251-604-4785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "AUDREY",
        "middle_name": "PHILLIPS",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-08",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AL",
            "license": "A0310068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED NURSE PRACTITIONER NUMBER",
            "identifier": "A0310068",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benefits Understood Counseling Services
• Elizabeth April Benge
• Christopher Benn, PA
• Thomas Patrick Benner, LCADC, MS, MAC, SAP
• Alyssa Leone Bennett
• Daniel Bennett
• Daniel James Bennett, PSYD
• Elizabeth H. Bennett, C.R.N.P.
• Jatonia Latavia Bennett
• Irma Bensinger, D.O.

• Adult Health Nurse Practitioner in Columbia, MD
• Providers in Columbia, MD by specialty
• Adult Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.