Individual provider Active NPI

Larry D Bennett

  • Chiropractor
  • Porterville, CA
National Provider Identifier
1912084591
Registry record updated Oct 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC0291190 Issued in CA
Practice address
130 N Villa St
Porterville, CA 93257-3218
Phone
(559) 784-9355
Fax
(559) 784-9359
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
29119CAMDClinical Social Worker
DC0291190CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Larry D. Bennett Chiropractic Inc. Chiropractor CurrentSince Mar 10, 2014 Accepting new patients

Locations

130 N Villa St
Porterville, CA 93257
Phone (559) 782-3090

560 W Putnam Ave
Ste 4
Porterville, CA 93257
Phone (559) 310-9824

130 N Villa St
#B
Porterville, CA 93257
Phone (559) 781-4500

1279 W Henderson Ave
Porterville, CA 93257
Phone (559) 310-1238

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC0291190 CA Primary

Addresses

NPPES NPI Registry

Primary practice location

130 N Villa St
Porterville, CA 93257-3218

Mailing address

1279 W Henderson Ave # 338
Porterville, CA 93257-1454
Phone (559) 784-9355

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
DC0291190MedicaidCA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 1, 2014.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412121600000",
    "number": "1912084591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1279 W HENDERSON AVE # 338",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "932571454",
            "telephone_number": "559-784-9355",
            "fax_number": "559-784-9359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 N VILLA ST",
            "city": "PORTERVILLE",
            "state": "CA",
            "postal_code": "932573218",
            "telephone_number": "559-784-9355",
            "fax_number": "559-784-9359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "LARRY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2014-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC0291190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DC0291190",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Porterville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2014; 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.