Individual provider Active NPI

Andrew Bennett

  • Gerontology Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1992371082
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP61200870 Issued in WA
Practice address
1660 S Columbian Way
Seattle, WA 98108-1532
Phone
(206) 762-1010
NPI assigned
May 31, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN60865808 WA
Gerontology Nurse Practitioner 363LG0600X AP61200870 WA Primary

Addresses

Primary practice location

1660 S Columbian Way
Seattle, WA 98108-1532

Mailing address

1660 S Columbian Way
Seattle, WA 98108-1532
Phone (206) 762-1010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20240315003532 WA Order and Referring Only - Nurse Practitioner 7012353782

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AP61200870WAMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1622419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1992371082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 S COLUMBIAN WAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981081532",
            "telephone_number": "206-762-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 S COLUMBIAN WAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981081532",
            "telephone_number": "206-762-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-31",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60865808",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP61200870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.