Peter G Bennick, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601001555 Issued in MI

Practice address

401 W Greenlawn Ave
Lansing, MI 48910-2819

Phone

(517) 334-2337

Fax

(517) 432-1167

NPI assigned

Oct 30, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1162166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992881221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "D128 WEST FEE HALL",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488241315",
            "telephone_number": "517-355-3503",
            "fax_number": "517-432-1167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W GREENLAWN AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489102819",
            "telephone_number": "517-334-2337",
            "fax_number": "517-432-1167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNICK",
        "first_name": "PETER",
        "middle_name": "G",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601001555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Demetria L Bennett, MA
• Karis Bennett, DO
• Lisa M Bennett, CRNA
• Michael Bennett, LLMSW
• Molly Bennett
• Latoya Benson
• Maurice Benson
• Zachary Bepler, DPT
• Cheryl Berdeski, CSW
• Nora Berens, MD

• Physician Assistant in Lansing, MI
• Providers in Lansing, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.