Active NPI
Nathan Douglas Bennion, PA-C
- Physician Assistant
- Colorado Springs, CO
National Provider Identifier
1912476292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA.0005577
- Practice address
- 2767 Janitell Rd
Colorado Springs, CO 80906-4102 - Phone
- (719) 365-2888
- Fax
- (719) 365-1577
- NPI assigned
- Nov 16, 2018
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA.0005577 | CO | Primary |
Addresses
Primary practice location
2767 Janitell Rd
Colorado Springs, CO 80906-4102
Mailing address
2695 Rocky Mountain Ave Ste 150
Loveland, CO 80538-9071
Phone (970) 624-2412
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA.0005577 | CO | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544572800000",
"number": "1912476292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
"city": "LOVELAND",
"state": "CO",
"postal_code": "805389071",
"telephone_number": "970-624-2412",
"fax_number": "970-490-4153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2767 JANITELL RD",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809064102",
"telephone_number": "719-365-2888",
"fax_number": "719-365-1577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENNION",
"first_name": "NATHAN",
"middle_name": "DOUGLAS",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-11-16",
"last_updated": "2018-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CO",
"license": "PA.0005577",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.