Wendy Dawn Benton

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-079781 Issued in AL

Practice address

122 17TH Court NE
Fayette, AL 35555

Phone

(205) 932-3900

Fax

(205) 932-3941

NPI assigned

Apr 21, 2011

Last updated

Apr 21, 2011By 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

Medicare fee-for-service enrollment

Enrolled in AL

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

Medicare enrollment (NPD)

Enrolled

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.

• Pinnacle Physician Group, LLP

  • Hospitalist Physician
  • Tuscaloosa, AL
  • NPI 1609008176
  Medicare reassignment NPD

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

{
    "created_epoch": "1303344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303344000000",
    "number": "1992096275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 17TH COURT NE",
            "city": "FAYETTE",
            "state": "AL",
            "postal_code": "35555",
            "telephone_number": "205-932-3900",
            "fax_number": "205-932-3941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 17TH COURT NE",
            "city": "FAYETTE",
            "state": "AL",
            "postal_code": "35555",
            "telephone_number": "205-932-3900",
            "fax_number": "205-932-3941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENTON",
        "first_name": "WENDY",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-21",
        "last_updated": "2011-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-079781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Scott Allison
• Jerald Jason Ayers, D.M.D.
• Natalie Watkins Ayres, DPT
• Leah Newton Bass, PHARMD
• Joseph M Bennett, DC
• Bolling Apothecary Inc
• Bolling Pharmacy, Inc.
• Austin Hamilton Brooks, MD
• Cortney Brown, CRNP
• C & D Pharmaceuticals Fayette Inc (Cannon Apothecary)

• Family Nurse Practitioner in Fayette, AL
• Providers in Fayette, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.