Kinneathea Denisha Bennett, NURSE PRACTITIONER

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

AP133353 Issued in TX

Practice address

5414 Fredericksburg Rd Ste 100a
San Antonio, TX 78229-3641

Phone

(210) 468-0800

Fax

(210) 733-8649

NPI assigned

Mar 7, 2017

Last updated

Sep 29, 2022By 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 2

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Advanced Internal Medicine Practice PLLCGroup PAC ID 6305187865, 3 clinicians

Applebaum Physiatry PLLCGroup PAC ID 8729453436, 141 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Advanced Internal Medicine Practice PLLC

  • Internal Medicine Physician
  • San Antonio, TX
  • NPI 1295299808
  Medicare reassignment Care Compare group NPD
• Applebaum Physiatry PLLC

  • Physical Medicine & Rehabilitation Physician
  • Oak Brook, IL
  • NPI 1700598059

  TX

  Medicare reassignment Care Compare group
• Vpa of Texas PLLC

  dba HarmonyCares Medical Group

  • Family Medicine Physician
  • Irving, TX
  • NPI 1679510499
  Medicare reassignment NPD
• Regency IHS NPS LLC

  • Nurse Practitioner
  • Victoria, TX
  • NPI 1619432986
  Medicare reassignment
• Vpa of Texas PLLC

  • Clinical Social Worker
  • San Antonio, TX
  • NPI 1578175865
  NPD
• Radiation Oncology of San Antonio, PA

  • Specialist
  • San Antonio, TX
  • NPI 1184789232
  NPD (past)
• Renal Associates, P.a.

  • Ambulatory Surgical Clinic/Center
  • San Antonio, TX
  • NPI 1881125870
  NPD (past)

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

{
    "created_epoch": "1488844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1902346141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 KIRTS BLVD STE 100",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480844135",
            "telephone_number": "248-824-6623",
            "fax_number": "866-618-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5414 FREDERICKSBURG RD STE 100A",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293641",
            "telephone_number": "210-468-0800",
            "fax_number": "210-733-8649"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3551 Roger Brooke Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Sam Houston",
            "state": "TX",
            "postal_code": "782344504",
            "country_code": "US",
            "telephone_number": "210-916-0883",
            "fax_number": "210-539-8633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "KINNEATHEA",
        "middle_name": "DENISHA",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-07",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP133353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370823204",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ACADEMY OF NURSE PRACTITIONERS",
            "identifier": "AG0117008",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabriel Arlen Bennett, RN
• Girly Bennett, M.D.
• Hannah Bennett
• Jason M. Bennett, M.D.
• John Anthony Bennett, CCP
• Linda Bennett, LCSW
• Marcie Bennett, P.A.
• Penny Bennett, PHD, MSN, NNP-BC, FN
• Robert Daniel Bennett, MD
• Sarah Elizabeth Bennett

• Adult Health Nurse Practitioner in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Adult Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.