GARRETT BENNETT M.D. NPI 1174884431

NPI Information

NPI: 1174884431
Provider Name: GARRETT BENNETT, M.D.
Classification: Radiology - 2085R0204X
Entity Type: Individual

Specialization: Vascular & Interventional Radiology

Organization: PARKVIEW HEALTH SYSTEM INC

PECOS Registration: Yes

Address:
100 NAVARRE PL STE 5500
SOUTH BEND, IN
ZIP 46601
Phone: (574) 647-5200
Get Directions

Garrett Bennett, M.D. is a vascular and interventional radiology radiology in South Bend, IN with 12 years of experience. The provider is a radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. Garrett Bennett, M.D. NPI is 1174884431. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

100 NAVARRE PL STE 5500
SOUTH BEND, IN
ZIP 46601-172
Phone: (574) 647-5200
Fax: (574) 647-5210

The NPI 1174884431 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/4/2012 and was last updated on 3/30/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology	306317	LOUISIANA	No
2	2085R0204X	Radiology	Vascular & Interventional Radiology	01082465A	INDIANA	Yes
3	390200000X	Student in an Organized Health Care Education/Training Program			LOUISIANA	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	300028176	MEDICAID	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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